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. <br /> D.�tB��BG a�ceo wo,w�re�-,n. _ 6�10—.290 <br /> Application F or ema.oec�.• <br /> PdJ[3LIC WORKS PERMIT °°°,oeFeeF°° � <br /> 4ssFOD� FeePaid S n <br /> Balarce Due S L�On <br /> Print or Type Only <br /> �►r�•a.n��.�iJa.� �7da ��..� # 7�Z �e�a���'`' l�'a0/ �s9-3�wS.6 <br /> Owner MaiFing Address City ip Phone <br /> Sa,wl�t.. <br /> Applicant Meiling Address City Zip Phone <br /> Describe Proposerl Work <br /> Co,a.,9 � <br /> � �ea.,� /11`v L <br /> W <br /> Proiect Address�if known) ���7— �ET/l�O�E'� �l�E _ _ � <br /> Attech four(4)copies ot plans for proposed work• Oraw to scale and note the lollowing as applicable: � <br /> • P•operty Lines • Centerline ol street � <br /> • Outline and dimensions ot ull existing and • Indicale Norih <br /> proposed structures on the lot • Show eny proposed grading changes <br /> • Existing and proposed utilitios • Show measurements � <br /> DO NOT WR�TE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1, All calls lor inspection shall be made 24 hrs.in advance-phone 259-881$. � <br /> 2. All work shell be pertormed in accordance with ihis permit and cunent Ciry of Everett Design and Construclion <br /> Stendards end Specilications <br /> -3. Call Location Underground Service 48 hrs.6efore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> O <br /> � <br /> � � <br /> O <br /> a <br /> ^,I, ACKNOWLEDGEMENT OF CONDITIONS <br /> ���9 The undersignetl owner/applicant hereby agrees to holA and save harm� <br /> less the City ol Eve�ett from any and all claims loi damages, costs, <br /> / / ' ezpenses, or cau,es of action that may arise becau�e of installalion <br /> �_7��3('�/� C�� 5 ? .�.b and maintenance ol Ihe imProvemen[ or other ri9hbof�waY use here�n <br /> y�''"' applied lor and luriher agrees to remove same upon notice irom ' , <br /> Approved for Consiruclion /�j Dale City and to eplace blic properry damaged thereby. <br /> �-�.-���J���/Lr���� � .'��' G� l <br /> FIN7CL I' �PIQS ECTION Date � � �1— <br /> �Approved as Conslructed ignature ot Applic ate <br /> evereti PUBLIC WORKS DEPARTMENT WORK AUTHORI BY THIS PERMIT MUST BE STARTED WITHIN <br /> 0 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett.WA 98207 BE DILIGENTLV PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone: 259�8815 CANCELLED BY TNE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS CURATION. <br />