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vub'..n Wo��a Pe�mn / � %�'—?- <br /> e�� —�Scl�L7�(�,(� <br /> mn� o�n� • <br /> qpplicalion For _ - � -- - <br /> ��.Li¢wm�ePre S <br /> PUBUC WORKS PERMIT ���r�«� -- <br /> , ,��,.� �..,.�..�� s-- -- <br /> P.� . .U��. S — <br /> L+l �� --_— _— <br /> Print or Type Only <br /> H <br /> � yy ' _ 7n �.. � <br /> ,g ] <br /> G: Z�p Phone <br /> H �HOwner Mailing Adtlress <br /> FC f� — <br /> H �1 <br /> Cily Phone <br /> � H � a �n� tvlailin9 Atldress Z�P <br /> ��„� qpplicant <br /> xz <br /> H <br /> CnOh �Pe.� f lenln ✓ - --- <br /> y DeSCnbe Proposc�Vda'R <br /> H^ � g - __ <br /> Y.� n W <br /> � N� <br /> � � .Cc�'f�c'� .Y,T �l�/. � <br /> � ~ y Proiect��ddress lil known) `���/C� /, �f� �^-- <br /> N � <br /> g H N <br /> O ty W Ntach�om 1�1 copies of plans lo�Pmposed work� Draw to scale and nole.CC^�,ev+in9 oi 5 PPe�'�hle'. <br /> � � � • Property Unes • Indicate Nnrth <br /> • Outline a�d d�mensio�s of all exisling and � $hOw anv p�opoSeA 9�idin9 �.han9es <br /> y H [/� pmposed strucWres on Ihe lot � Show measurements M <br /> � � • E.isting and O�oposed utilities W <br /> � DO NOT WRI7E Bf_LO1N iH1S LWE O <br /> PERMIT CONOITIONS � <br /> � 1.All calls br inspeclion shall be made 24 hrs in aAvai.��a�Phone 259•8810. <br /> � 2.All work shall U?pedormed in arcoNance wilh Ihis P=-�md and current Gry of Everett Design and Construction <br /> L� Standards and Specifications � <br /> � 3.Call Location Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1•S00•424•555 . <br /> i O� f/= _iJ• � /_�: �i<J��Ji_-Jc<� C�l�s'c.l.;'_�. � r"[�.�C! ,. . . <br /> i'sci�c- Sc,9/ft%e;T A�E <br /> � � (Ii�Y�i-�._ �?._�,�.�,�da� � <br /> � <br /> ��,.��( y , . N��-,�- T!C Il�%ii"-�' /i)��;i i'. '�„� . ' , � <br /> � � <br /> 1 � `..%�. ;ii! .: � <br /> ` <br /> �v�� L�.� <br /> �GKNOWLEDG[1.1ENT OF CONDI710N5 <br /> Thr unde�siy'eA owner/applicai��he�eby a9rees to holA and sa�'e h.�r��" <br /> ��� — luss the Gty ot Everett irom tfny and all clalms lor dmn�9�'% �'.�sts, <br /> expense;. or causes ot aclion that may ari�:e Uecause c� �i�stallatio�� <br /> � � and maintenance ol the improvement or other n9hPobwuY ��sc h����° <br /> � r� ' ✓ ;�/'�-,_C.: t� - '1 ���-•7 % licd for d turther o9recs to remove s:ame uPon nahrc ha�� ihc <br /> � ' � Date � t�and`O d_�P�:L���prope�N dama9eA thereby. <br /> App�� ed o mstruction � <br /> � � �� � � <br /> � <br /> � /;/ �_'-�('�' --' I �/ 1_� <br /> a�+ — �_ <br /> o.,i� _._ ,. -� o��� <br /> FINALI 5 � I y,i ,;: -e--� F1'�cem <br /> Approved asConslructed I �.'.�_���t AUTNOFIZGD BY 7HIS PERMIT IAUST BE SiANTED W�THIN <br /> 0 i,�i.�iq� PUBLICWORKSDEPARTMENT IP.� ��YF OF DQTE PERAIR IS ISSUED AND TH[PEAFTER IS TO <br /> 32o0CedarStreet I BF � 'LIG[NTLV PURSUED TO COMPL[TION. THIS PERMI7 1.1AY BG <br /> Everelt.\NA 98201 G�����«ED BY TH[CITY UPON ANY STOPPAG���`�'�u�h nN T�IIS <br /> Ptwnc 2S3-�oto ;RC CC1 UVER 90 D�YS DURATION- <br />