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� PUBLIC WOR � P ���� � °�" ��. <br /> �� <br /> Eve�ett.WA%201 ,�PR �01996 P""'"• <br /> TYPE OR PRINT ONLY . . ... .... ....•••.•�•... RbMe Worla fea f <br /> ._. .. ....,... . <br /> CgITY, OR EveRErT <br /> �ww �teJ 7�r/O Si�f/Y'��r !•�✓� ��vf�'�� 9�i0 3 30S'�b�i�i _ <br /> Ownx MaINn9Add��� Gh bP �» <br /> 51.,..� <br /> �va�•�+� ��w� �r aa � <br /> Describe Proposed Work � � R u,1a-�vw�f4 �D l�.a�✓ . � <br /> ��.,��v + d1L�,� s�r•.�. �'•�•M•. uN�s�d G�1.� � 'W- aF sww ad � <br /> � <br /> '�L� xoilh �s of��a cun�. 'fv Cow�rw� a �Q.vue�. �Iw � 1�af /�/� <br /> e.wka�, Nw. M�v. � �+. V� <br /> PROJECTADDRESS(Hknown) i�L/��/wN�P t,,.,,i� i..ur�� �.� � <br /> Atlech four(q copbs M plane for proPoeed wak-Draw to acda and note tha fdbwirp H�ppNcabb: <br /> Rropxty Llnes �OWlins and Eimenabna o1 all ezlatkp and qopoaed shuctu�es on tha bt 'ExleNiq and p�opoesd utiNtbs � <br /> 'CenMrH�x o1 euaM 'Indkate North 'SAow enY P�Po�G��9��Gs+ 'Show meuuremenb � <br /> p0 NOT WRITE BELOW THIS L1NE <br /> PERMIT CONDITIONS: Z <br /> 1.PJI calis for inspection shall be made 24 hours in advance-phone 259-8810. O <br /> 2.All work shall be performed in accordance with this permit and cument City of Everett Design and <br /> Construction Standards and Speciflcations. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-900-424!f666. H <br /> � <br /> O <br /> a <br /> �NlilAl �NSPECTION <br /> KIRK BROOK6 I <br /> 96 -- � <br /> �ATE <br /> ACKN�:rvLED(iEMENT OF CONDR70NS <br /> The undersigned owner/applicant Mreby epnes to hold and�aw hrml�s <br /> the Ciry of Everott hom any and sA elaims for d�mpss,cwb,acp�nws,a <br /> ApqoveE fa Conatructbn Date uuse�ot aetbn that may aiiee becauas M kuLpatbn arW mYntsw�ca d <br /> 1M knprwert�ent orother rightof-wey uss henlo�pNed for and fuMerapne� <br /> to rertrove same upon notke hom th�Ciry and to replsce pubNc propMy <br /> demaged thereby. <br /> FINAL INSPECTION Date � � � d <br /> Approved as Constructed 7'�4-9G <br /> Signature o1 1 Wte <br /> WOHK AUTHORIZED BY THIS PERMIT MUST 8E STARTED WI7HIN 1 BO DAYS OF OAlE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILI6ENTLV PURSUED TO <br /> COMPLEf10N.THIS PERMIT MAV BE CANCELLED BY THE CITY UPON ANY STOPPA6E OF WORK ON THIS PR0.IECT OVER BO DAYS WMT10N. <br />