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Date� TO POSTING %i��� <br />Appllcalic•r For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />AAdress <br />N� <br />PeCI¢ Won� Parmil � � //1 � � <br />a�,, o�o�.. �%�s'yrL — <br />PubueWerk�Fa� -- <br />TaM Fea s _ <br />len �nol FN P�10 i <br />B�bncs D�� f Z� . <br />3,�y-9a,� <br />Phone <br />� . • .,. r. �. . � • • i. � <br />Project Addreae pl known) <br />Atfach lour (4) coples of plene for propoaed work - Drew lo scale and note the lollowing as appllcable: <br />• Property Linee • Cenlerline ol alreet <br />• Oulline and dlmonsions ol all e�isting and • Indlcete Norlh <br />proposed etructursa en Ihe lot • 5'�ow eny proposed grading changea <br />• Ezislinp end propoaed �i�litles • Show meesuremenla <br />PERMIT CONDITIONS <br />1. All ulla for I�tpeclion ehell ba made 24 hre. In edvence - phone 259-8810. <br />2. All work ehell bs peAormed In accordance with thia permit end current City ol Everelt Deaipn and Conatrudlon <br />SteMaros �nd SpeclNcallona <br />3. Csll Locatlon Underpround 9ervice 48 hra betore you dlg. TOLL PREE NUMBER 1-800�4245555. <br />�• ZoN�N� ('o�:� �.�en ��rS o2�u�kinY I�� � a-�µ -i�, <br />�O � 1�.; �'Rt�NTI+E 2-C7' Ft2ei.l'r �C—Tf3Ace.1�_ <br />�. G i�-Y s�rcc�i-s sH,���. �. �-r� �u=�► a-r .�.-n�. <br />�• G���-8 C vrt�'2 n�N� � � 7c ua�K k� Ns�J �w,� �� �`'h) <br />��JY 7M+�hG�E :itf'M.l. P�� QG-YLi1CCC�D GY (Ht_ A}�.IC�v1Q. <br />q.� <br />_�Q,�l.-� �M � �-'�sL. 1 I - 2. 7 _ �� <br />nroved � �-r Construclion Dale <br />IAL INSPECTION Dale <br />nroved us Construcled <br />�werptt PUBLIC WORKS DEPARTMENT <br />� 3200 Ceder Streel <br />Everell, WA g8201 <br />Nhona: 258•8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />�1 <br />� <br />� <br />O <br />� <br />� <br />� <br />a <br />The undersigned owner/eppllcant hereby egreea to hold end seve herm• <br />less Ihe Clty ol Everetf�lrom any and all claims for damegaA cosla <br />e�penses, or ceuces ol action Ihat mny ariso beceuee ol Innlallatlon <br />end maintenence ol the Improvemenl or olher rlghl•ol�way use hereto <br />applied lor and further agrees lo �emove eame upon �otice Irom the <br />Clt and 1 replace pu fc perty demaged thereby. <br />2 /3 U <br />Slgnature ol pplie Date <br />WORK AUTHORIZED BY THIS PERMIi MUST BE STARTED WITHIN <br />1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DIIIGE.NTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPA(3E OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />