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_-_- — <br /> � <br /> :N <br /> � �'j/� <br /> Date��/ � . VUFM1[WOrLs Parmil� �� -�`p—_ <br /> Cl�il� Onpl • <br /> ADPIir,�tion For � <br /> PUBLIC WORKS PERMIT Q �,°;°°�°�ap°�° 5 — - <br /> pi•�sx�nni F...•oae S �— <br /> r� � <br /> r_ �+ � e,�.,�,..n,:�. S �n <br /> Print or Type Only a <br /> �:; M �OZ-3zZ`�o/8r93/ <br /> '�,l.�,t�� L ���,--�/1-� ��.1�.�. _�r � �?�3 �s�i-/3�y <br /> OWnP� nna��irv. :l,:drub5 �'"' � O W c.�� Phonc <br /> .�-i O �2 W <br /> U � L U <br /> c <br /> APPliwn! —_,-In�.:: ,�rtN.rr,s.-- -_—__—. , . Lp Phonn <br /> Describe Proposrd work ��^'�—�'la—_'-!v_��j`��,'-- '� J �—/�] I� �� �^ . <br /> �✓ {���n A � _w.`+�Yt _/��✓�.J• ���_-�OJ��"��--�;�;��Lh�T_._ <br /> F � <br /> r�e T � S � — -- -- - - _ -------- — <br /> _ _- - - Q ___ _ ------------- W <br /> Project Addres5lil known! ����--�`4��7U�'r� -"��s------------ — � <br /> A�taeh 1eu� (4)coP�es ot Plans fa PrnP��sed wvr.: � D�av: tn -,:.t�.. .�-.i n..h•ihe:oqc�vinq as anUhcah�e � <br /> • Pronariy Lmes • Gentert:nn nt sirevt � <br /> • Oulline and dimension5 0� all existinq and • Ir.r!iral�� Norih <br /> propo5e0 structures on the iul • Snem•any r.ropusetl gra7�na ;�anors <br /> � Ezislina and pwposed utildies • Shnw mn,�surements M <br /> W <br /> DO NOT WRITE 6H_OW IHiS LWE O <br /> PERMIT CONDITIONS <br /> 1.All cails for inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 5 2,All work shall be pedormed in accordance with this permit and current City o�Everett Design and ConstruCtion <br /> � Standards and Speciliwtions. <br /> r� 3.Call Location Uoderground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> � �. /�(%fJ /OG O� t'��l Q �r.n .rnvri OT 2S � 6ack O <br /> 7''y^o�+'� /OP Of Sfzc�p S�ePC_ � <br /> J� �Lth1�' heuJ �C� 4�-c�„ �,i��! yraSS or z'vy � <br /> (Y" T �/�Lh CO�'^PC¢�C� . O <br /> a <br /> AChNOVJLE�CiEMENT OF CONDITIONS <br /> P�.� �LA�✓Niti!/ ih���m�b����:�n�AowneVapnhcantnerehyagreestoholdantlsaveharm- <br /> �.0 ---- -- - �" ---� ii..;q :i��. i.dti "� ��eietl Irom anv and al! claims :or damages. costs <br /> . r•.penses or �auses o� ar.�io� that may anse betause M mstallatinn <br /> L ,/ �. anA ,�aintenante n! Ihp improvement or other nght�obway use hweln <br /> ����p-t�'f-- —��le ,�Q/`". . ,�ri,i��r: lor anA lur7her aqrees to remove sam�. uPon notice from O�e <br /> i <br /> Approved lor Constru ion � �^ . C!. :��•.d tn replaca oubhc aione��Y�amayeA thereby. <br /> 6-iy s 6 <br /> FINAL INSPECTION � '�Q �II � ^ Dat� <br /> Approved as GonstructeA ig +tuir ol I�can. <br /> j IVORY. �aUiHORIZfD BY THIS P[RMIT MUST BE STARTED WIIHIN <br /> � PUBLICWORKSDF.PARTMENT I t90 DAVS OF DATE PERNIT 1S ISSUED AND THEREAFTER IS TO <br /> 3200CedarStreet �I B[ D41G[NTL1' PURSUED i0 COMFLETION. THIS PERMIT IdAV 8E <br /> Everett,WA 98201 ', �4NCELLtD BY THE CITY UPON ANY S70PPAGE OF WORK ON THIS <br /> Phone:259-8870 PapJECT OVER 90 DAYS DURATION. <br />