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�:�i � <br />�� <br />O .o x <br />C, H <br />ayxti <br />H X� <br />�C f� <br />H� <br />oxo <br />'{1 H'i1 <br />(p H <br />� O� <br />OH <br />�^ �, 8 <br />y, V � <br />�H� <br />HH <br />8y <br />H <br />('! l7 V1 <br />� r� r <br />x H l�i� <br />H O fn <br />i Date 7 11 90 � <br />I � <br />� AppliCa(ion For <br />, PUBLIC WORKS PERMIT <br />Print or Type Only <br />. <br />Puo��c Wm�s vermn . <br />❑ioq o�ni • �0/25099 _ <br />Pwuc Wa��e Ieo <br />iotaifee 5 <br />Lev Appl io-� Pau] $ <br />e��.,��.., o�� 5 <br />Uill & tlancy Roasmen 632 Wotmore EVeratC 982J1 252-1309 <br />Owner Mailin9 Address City 21p Phone <br />OWf1�T <br />Describe Proposed Work <br />Adtlress City <br />« <br />ZiP Phnne <br />?roject Address lil knnwn) b3Z woLma�zt! <br />Attach lour 141 copies o� pians lor pmposetl work • Draw to scaie antl nme the �ouowing as appiicabie�. <br />• Property Lines • Genterlme of strcet <br />'� OuUine a�d dimensions ol all existing and • Intlicate Nmth <br />propOsetl structures on the lot • Show any prOpDSBtl g�adin9 Chanpes <br />• Existing and proposed utilities • SF,ow mcasurem�nts <br />L <br />PERMIT CONDITIONS <br />1. All calls for inspecti�n shall be matle 24 hrs. in ativance - phone 259•8810. <br />2. All work shall be peAormed in accordance with this permit and wrrenl Ciry ot Ev?rett Design and Construction <br />Stantlards and Specilications. <br />;i. Call Locafon Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424-5555. <br />/-� � <br />�i�e Cvoz/:. I"..t�-�<<�f 7�T` if��.�r.�, c/' <br />' �� <br />.:.����l,`- <br />;, //- r%C� <br />Appmved br Consirudion � <br />W <br />� <br />� <br />� <br />ZI <br />O. <br />r '. <br />� <br />O <br />a <br />ACKNOWLEDGEh1ENT OF CONDITIONS ' <br />The untlersignetl owner/appLcant hereby agrees lo holtl antl save �arm- �. <br />�less ihe Cily ol Everett Irom any and all clalms lor damaqes. costs. �: <br />e�penses. or causes o� adion Ihat may anse be[ause ot in��alla!ion <br />and meinlCn.lnCe O� �he imprOVfm2ni Of O�hef figh��O��W2y USC h2r2i0 <br />applied foi and luriher a9iee5 to remove same upon notice irom ihe ' <br />Date � Cily:;nd lo replace pubGC property dama9etl therehy. � <br />FINAL INSP[CTION Datc ', <br />Approvetl as Constmcled Si9naturc ..� ApPlicant ���� i <br />everett PUBLICWORKSDEPAR7MENT WORK AUTHORIZEG BY THIS PERMIT MUST BE STARTED WITHIN � <br />� 320UCetlarSt�eet 160 DAVS Of DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />Everett, WA98201 BE DILIGEMLV PURSUED TO COMPLETION. THIS P[PM111T MAY B[ <br />Phono: 259�8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PF70JEC7 OVER 90 DAYS DURATION. i <br />