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� . N <br /> Date1�}/�/L.C�/V 1 PuLFc.f/orAs Vprmil� _/_�^_J/ 4l I�-_ � <br /> / BI�IA Drnl . .._�J_R����_. <br /> ApPhcation Fo� � <br /> PUBLIG WORKS PERMIT °°°°°W°,"'°� - --- <br /> ,o„�F,.� s_. <br /> lces Anttl f.e PaN s.T- <br /> /� i <br /> E1TITn�r f1i�� .S O(O <br /> Prim or Type Only <br /> nn� J�klQ 7a�P-ln0''� R (Y,1�1 �vF�,�71`- ��a03 3�r5=�/.�GO <br /> Owne� Madmg AAd�n55 City 7_ip Phone <br /> �1�-1�1.u,wad C�nf �rx�e _ <br /> qpp�i�e�� Madmg Atldicss Cily 2ip Phone <br /> Descnbc Proposed Work ___J_U1/d[_- ����� <br /> W <br /> Project Address U� koownl _�"�O���G7 "� -� � ��j <br /> Atlaeh four 141 cop�es ol plans lor proposed work� Draw lo scale and nole the lollowiny as anU�icabl��. � I <br /> • Property l�nes • Centerime ol street � i <br /> • Outhne and dimensions ol all ezlshng and • Indicate North � <br /> • Show any proposed grading changes '� <br /> aroposed sVi ctures on Ihe lol �, <br /> • Erisbng and proposed uldAies • Show measuremenis � �. <br /> i <br /> DO NOT WRITE BELOW THIS LIN- � � <br /> I <br /> PERMIT CONDITIONS <br /> 1,AII calls for inspection shall be m�de 24 hrs.in advance-phone 259•881 C�. � <br /> 2.All work shell be pedormed in accordance with this permit and current Ciry uf Everett Design and Construction � <br /> Standarda and Specifications. <br /> 3.Cell location Underground Service 48 hrs.before you dig.TOLI FREE NUINBER 1-800-424-5555. � � <br /> � <br /> i <br /> O � <br /> � ' <br /> OG/26/ES B:50AM OOORN6493 <br /> / <br /> HOOOe�281 O ' <br /> ELDG t681.50 <br /> FLBG 5100.00 /� <br /> HECH f117.00 �� <br /> FLN CH 520.48 <br /> f• SRCH 53.50 <br /> ACKNOWIEDf,�_ ;�-f�lT C 'S��TIONS <br /> the undeisigned rnvnedappG�yQ��a^rebvQ¢,�q?��hold and save harm� <br /> less Ihe Cdy e� [verell iror� .��r� anA all claims lor damages, costs. <br /> _� ��� � expenses, ur causes of actr i ihat may arise because ol installation <br /> j� � r- J and mainlenanr.e ol Ihe im� 'vement or other nght-ol-way ase hereto <br /> �—L apP�ied for and 'urther ¢yrees lo remove same upon notice Irom the <br /> Ap e C str� � n � Cily and 10 r�place public p�opertv damagetl lhereby. <br /> ' /// �����'/�/s� <br /> FfNAL INSPECTION ,J�)�fe � � �� �� Date <br /> Approved as Conslructetl % o*� ignatwe ol Appficant <br /> WORK AUTHORIZED BY THIS PERMIT� MUST BE STARTED \NITHIN <br /> everett PUBLIC`NORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THENEAFTEF IS TO <br /> � 3200CedarStrect BE DIUG[NTLY PURSUED TO COMPLETION. THIS PERMII" MAY BE <br /> Everett.WA 90201 CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br /> Phone:259�88t0 PROJECT OV[R 90 DAYS �URATION. <br />