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/ <br /> Dates�s��u TO POSTING_r -''�,�,�[f(.Jc, ���,��:.,�:�,,,=o�„�:. ��f{_/�� zc�_ <br /> AppLGaiion For A'cy �en� ����1Y1_l.f -- <br /> PUBLIC WORKS PERMIT °°���r�";°�;:�`�� s /�s�-`s- <br /> less Aoo�Fer Paio 5 <br /> Print or Type Only � . � e��rrrt�w� � 5� <br /> HOH �. , � . . '. . . <br /> � r � <br /> �' .a l—�e �,�lf �c �» l /L/i i r�r/� P(2 �t�,�/��5 T i���.,� /-/ 6e/fl ���c� <br /> A4>-, � H Owner ��N1a0 9 Address� � , . City-' �Zip� � . . . � Phonc <br /> t" ymy 1 : , . , . . �. . <br /> Ha � / � � / (0(l� 1-lr�6utf �N��/GU l-vF�r+7�� S )L��i�,3/6/ <br /> z M � L) Nl6N /7rn � r -- <br /> K n �pplicant MaJing A�ress CAy 'ip Phonc <br /> H � <br /> � M � <br /> !A N Describe Pwposed Worh _ <br /> Hx <br /> [!7 O -- <br /> O ly-i d <br /> �� g - W <br /> I�V (7 .�.�a�yC� � <br /> � l—J—{—d��i �\�/�_ � <br /> a y� Pioiect Address lif known� --�— � � S 1"l 1 Il1 <br /> ty N y Avach lom�41 copies of plans lor pronosed wo�k-Draw to seale and nole tht�followm9 as anPhi,abie � <br /> ty y • Property Lines • Centetline of slree� /^ <br /> C H • Outline and Aimensions of all existing and • Intlir,ate Norih V� <br /> �n'^ d� proposetl structures �n Ihe lot • Show any n�aP�sm1�yac1•nq changes <br /> 3 � N • E*is�ing and propo5ed ulihties • Show measureinen�s � <br /> XH [�i� <br /> y p � DO NOT WRITE BELOW THIS LWE O <br /> PERIdIT CONDI710NS <br /> . t.All calls for inspeclion shall be made 24 hrs.in ativance-phone 259•8810. � <br /> � 2 All work shall be pedormed m accordance wifh this permit and current City ol Evereti Design and Consiruction <br /> Standards and Specilicalions. <br /> � 3.Calt Loca�ion Underqround Service 48 hrs.belore you tli9.TOLL FREE NUMBER 1•800•424•5555. � <br /> � _�y <br /> � 1 � ���� ��/j���e'V�"��tlS ��Y� �' Z?�9� Q <br /> / <br /> . I �_ . � <br /> � s I � I �,�� � vF.�c�.� J<-i'-� V♦ <br /> � !I�I �Cl'�'✓ �.'f�%I( r' ` � VAb��T`� � � <br /> _'-'.Ic::, �,.. �('a��..� � �'6�C/ �,Nor IL � �P Lvf=r .Y��`.>-�_. . a <br /> � � r <br /> �—��� �f«���, of� �h�na- �;,..�� ��. � 1� ���� �=��« � ��� ' ? � , - <br /> r.�, <br /> ` I � UV��E/ CON:� T_ (O� I �i'�.-. <br /> � �1�(�s'1G�� C�v��r�t-�—tt'� qCNNOWLE�G[MENT OF CONDITIOf�S � <br /> �I � The undersic�ned ownci/applmant I��erehy agrees to hold.ntl save horm� <br /> �� ---- less the Gly of EvereO hom any and all claims lor tlama9es, cosis. <br /> =1 ' ��� � expenses. or wuses oi action that may arise because of installation <br /> �_Z2 �� and mainlennnce ol Ihc impro�ement or other righ4obway use hereto <br /> ��� f� applied for and Wriher agrees Ir remove same upon notice Irom the <br /> Ap rovedA r onstruc io.� / Dale City and�o rep�ace pu6lic p�operty Aama9ed Ihereby. <br /> �i <br /> � � ! �r �_—'__ %' t�"�L- � I — . U. <br /> FINAL INSPECTION Date ' ��� � � <br /> ApP�ovetl as Censlructed �9 ature o(ApPlicant Date <br /> evrretl PUBLICWORKSDEPARTMENT �NOFK AUTHGRIZED BY THIS PE�MIi MUST BE STARTED WIiHIN <br /> � 3200CedarStmet 180 DAYS OP DATE PERMIT IS I.SUED AND THEREAFTER IS TO <br /> Evemlt,WA 98201 BE DILIGENTLV PURSUED 10 COMPLETION. THIS PERMIT M1tAv 6[ <br /> Phon¢259-B��O CANC[LLED DY THE CITV UPON ANY STOPPAGE OF WORK ON THIS <br /> PI70JECT OVLR 90 Ur:YS UURATION <br />