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Date � � �> <br />Applicetion For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />I�) ( ) <br />Owner <br />Describe Proposed Work <br />n^�,no�e,r� _. , <br />Project Address (if known) <br />Meiling <br />;��r� r <br />� <br />Attach four (4) copies of plens for proposed work - Draw to scale and note the following as appiicable: <br />• P�operty Lines <br />• Outline and dimensions of all existing and <br />proposed structurea on the lot <br />• Ezieting end proposed utilitias <br />V <br />P�Olic WOA� Permll � � w � <br />BIEp. Deo�. � <br />PublicWorkeFae 7i�1 �Yl <br />To�alFee S �"'�"v <br />� <br />�o. �oo� F.e v.ia i `� <br />Bal�nce0ee :��7-W <br />� <br />• Centerline of street <br />• Indicate North <br />• Show any proposed gradinA changea <br />• Show measurements <br />�� <br />PERMIT CONDITIONS <br />7. All calls for inspectlon shell be made 24 hra in advence - phone 259•881 5. <br />2. All work ahall be peMormed in accordance with this permit and current Ciry of Everett Design and Constructlon <br />Standarda and Specificetions <br />3. Call Locetion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. <br />�c-�- *` �3 (� �tR _ <br />� G,xcd e �r .c s�- � e ��i» ��.� 6 �� <br />pk 6/.t wo�� SH���, �.-,o� <br />� �Q"'n t ��%n� uPs��� <br />CI <br />�Q��,�C h)i^� G�on � <br />� o ��� 5✓�t' <br />7Cpproved for ConstiuCfion j Date� <br />_ ��� ���� /�%8-�'3 <br />INAL INSPECTION Date <br />everett PUBLIC WOFKS DEPARTMENT <br />� 3200 Ceder Street <br />Everett, WA 98201 <br />Phone: 259-8815 <br />W <br />F- <br />� <br />�� <br />� <br />� <br />u <br />H <br />� <br />O <br />a <br />ACKNOWLEDGEMENTOFC DITIONS <br />The undersigned owner/applicant hereby raes to hold and eeve herm- <br />less the Gity of Everet enY and clelma for demepes, costs, <br />�xpsnsas, or cause f actio thet m arlae becauae of Instelletlon <br />d m nten nce ihe im vement other •ighl•of•way usa hereto <br />ppl' d for d fu her r a to re e same upon notice from the <br />Cit e �plac p operty d ged thereby. <br />WORK AUTHORIZED BY THIS P RMIT MUST BE STARTED WITHIN <br />780 DAYS OF DATE PERMIT I ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />.1 <br />_ � <br />