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Date 8/[1/95 9s A z �� <br /> Pul�nr.lYorvs un.m�t� �✓ <br /> , AppliCaiiofl FOr ����q Depi • _ <br /> PUBLIC WORKS E'ERMIT �������_,�����=F�e <br /> ToulGre $ <br /> 'i�•ss aou� ro..aa�a 5 <br /> Print or Type Onty "'""""'°iv � �- <br /> Kirk A. May 5607 t7est Dr. Everett WA Home 347-4505 Work 356-3331 <br /> Owner �';v�.n,.; a,:d�ess Cn. Lr Phnnc <br /> Same as above <br /> APPficant _—_ t:..�i:,��a ar,r.�..ss �r,v � � Z�n _._____— p,iom---_ <br /> Describe PropoSed Work I wish to build a 6'_ fence alonq the access road leading down to <br /> Evezett Public Worl:s Lift_Station #23.___I ful�_understand that the fence will ue <br /> _ built on the road's riaht of wak and that the_ City has_the right to make me move the <br /> fence at anv time. ------------------ ------- W <br /> Project Address fil known! 56➢7_H'est_DL�_—______..__ _ _ � <br /> Attath�our 14) copies ol plans fo� n��uo>eJ�cu��- � D�av:ta.cal��an1 note the:c�iuwmg as anplicabk� � <br /> • Pmperty Lines • Cur,(eilinr_ al street � <br /> • Outline and Aimensions ot ali exist�nq anA � Ir�Ji�,3�9 Noith <br /> prOposetl S�NdurCS On Ihe lof • <hpw any ,^,roposed�ratlmg chen�PS <br /> • EziStino and prOposed utilities • Shnw mnasurements � <br /> DO NOT WRITE BELON' (MIS LWE O <br /> PERMIT CONDITIONS <br /> 1.All cails for inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.Ail work shali be pertormed in accordance with this permit and current City ot Everetl Design and Construdion <br /> Standards and Specifications. <br /> 3.Cali Locaiion Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424-5555. � <br /> � �� .�G> .G� .ecwv rnvv-a� ,ta cc��� �i(,�e <br /> aizvai �'vz an�,�.� �o�oa�.� �iG-.o �,z-eti rnuof O <br /> � /2en�wt,�0 aa` a�,-Eet-�nt,a� �.av,�.�.v � � <br /> F f.� �� � �� �� �d� � � <br /> � 6� � ��.� � s � O <br /> a <br /> ACKNOWLEDCiEMENT OF CONDITIONS <br /> Thn under�iqnetl owneVappliCant herCUy ag�ee510 hold and Save harm� <br /> --- --i less Ihe GAy o� [veretl from any antl all claims for Aamages. costs. <br /> � e�Penses. or causes of aclion thai may ans= I�etause ot mstallation <br /> � ' anA m,iintenance o! Ihr improvement or olher nght-ol�way use hereto <br /> --�a'S/—p�- I �t=d��d �cr anA fur�her aqrees Io remove same upon notice irom the <br /> Approved for Co cGon Dait; � C�tv,�i�lace Pubhr,nronertY damac�ed thereby. <br /> i <br /> i <br /> ,� �` �' j0-/3�9J�I ' <br /> FINAL INSPECTION Date I C'1.5 <br /> Approvetl as Constructed I Signatwe ol Anphcan! Date <br /> � PUBLICWORKSDEPARTMENT \1'ORK AUiHORIZED BY TH RMIT MUST BE STAflTED WITHIN <br /> 3200CedarStreet I 190 DAVS OF DAT.E PERM IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98207 BE DILIGENTIY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> Phone:259-8810 i CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> i PROJEGT OVER 90 DAVS DURATION. <br />