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Apphcatan For Date <br /> f 29��g � <br /> PUB� WORKS PERMIT public Works Pertnit k 30 <br /> `� ��`� �� <br /> I � ORKS DEPARTMENT <br /> � D 1� v tc, �J y 3 00 Cedar Street <br /> �� Eve t �198201 (a25)257•BB10 Building Pertnit N <br /> 9 �ggg A r9 <br /> �r p 2 � M A R 0 7 1 0 0 0 public Works Fee$ '7 3.3 � <br /> TYPEOR � To,�,- ' STING <br /> ; l=�'�;;C:TY . <br /> .--. ; ,n'Y ii. r��, 4�207 �425� 25Z-Z/G� <br /> �c�'���q/dh�,�4,E'�'� i��/ GJ6Tf2 '�' '� �d��l <br /> Owner Mailing Address Ciry LP �°^e <br /> ��uv �s,4 ✓n �E s�0�Bx Z9B /lau,�' 98 Z�z 131�) 79�f- 7Z+�v <br /> Appliwnt � Mading Address Ciry Zip Phone <br /> Describe Proposed Work � �' � <br /> � <br /> � <br /> � <br /> PROJECT AODRESS (if known) ��2F.7 w � � <br /> O <br /> Atlach lour(4)copies plans lor pro{wsed work-Draw to scale and note the lollowing il applicable; � <br /> •Property Lines •Outline and dimensions of all ecisting and proposed structures on the lot •Ezisting and proposed utili6es <br /> •Centerline of street •Indicato North •Show any proposed grading changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: O <br /> 1. All calis for inspeclion shall be made 24 hours in advance - pYione (»25) 257-8810 <br /> 2. Ail work shail be periormed in accordance with this permit and current City of Evereri Design and � <br /> Construction Standards and Specifications. � <br /> 3. Call Location Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800-424-5555. <br /> ,.�� ,��s c�a�c� /a-�.3 -99 � � <br /> �. P � � a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � The undcrsigned ownedapplicant here6y agrees to hold and save hartnless <br /> ihe Ciry of Everen any and all claims loi damages,costs.expenses,or <br /> causes ol acti h may arise because of instaliafion end maintenance of MA <br /> p or o ion a e improv " or o r ri f-way use hereto app� arM further agrees to <br /> - . �r�C-! a ebe u L �rom the Cit and t puMic propertY m- <br /> .2—S- Ou <br /> FINAL INSPECTION �a�e Y I� I J � <br /> Appmve A as Co n s t r u c t e d a e <br /> igna ure p ican <br /> WORK AUTHOR�D BY iHIS PERMR MUST BE STAHTED WITHM 1B0 DAYS OF DATE PERMfT�S ISSUED AND TH EAFTER IS TO BE DLK'iEMIY PURSl1E�T� <br /> COMpIFl1pN.TNIS PEFVVIR MAY BE CANCELLED BY THE CfTY UPON ANY STOPPAGE OF VAJFIC ON TMS PRQIECT OVER 90 DAYS OURATION. <br />