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HxCr]H <br />C�1 Cs1 �y <br />O � x <br />�Hxc~i� <br />yxH <br />fC C] <br />H 71 <br />� V1 M <br />x <br />��d <br />��g <br />i]Y (❑] <br />9 H [�1 <br />4 <br />r+ H <br />N <br />Fi <br />C� C p� <br />��C11 <br />HOfyA <br />� <br />- <br />Date 'j '�' '��7 <br />Apphc:dinn Far <br />PUBLIC WORKS PEF�MIT <br />Print or Type Only <br />Applicanl <br />Rtadmg <br />Mailing <br />City <br />City <br />r„v„c:, ,..v.i�.�. �p—J-� � _ <br />Fli�f�� orn� • �-7 �_0��� <br />�•,—,�,�,�,vo,k,F�o S <br />io�a� rao �— <br />t�.:,::.oni v�.�.v.��o 5 _ <br />. ,.., . ., „ 5 ?i;-- — <br />��� <br />Phono <br />Phone <br />Des�ribePrcoosedWork��fll .S'1`,�_T�! A�n��'�lQ%/� �Yi��{ l✓ / _ <br />Proieui��:iesslilknownl J�C%!% —' `��'�L_��fi.0 ���� <br />Atlach c-ui �, . �opies ol plans lor proposed work - Draw to scale antl note Ihe lollowing as apPlic�hlr� <br />• Properly Lmcs • Centetline al street <br />• Outline and dimension= ol alt eal;ting antl • Indicalc Norih <br />proposed SlrucWres on ihe lot • Snow any propo�ed 9rnA�ng chnn9es <br />• Eaistin9 antl pronosod uLl�hu:� • Show measurcments <br />rERAPT CONDITIONS <br />t. Ail calls Ior u•,spectlon s!iall he ma�i� :a hi;. in ativance � phone 259•681 5. <br />; All work sh,�ll be pedormctl m accomance wilh Itis perm�l and current Cdy ot Everetl Desi9n and Conslruction <br />S�antlartls and Specili; aiions. <br />.,. Call Location Under�round Service 48 hrs. be�ore you dig. TOLL FREE NUMBER 1•800•424•5555. <br />iNS'PALL NEW DRIVEWAY PER CITY STAND <br />AND GUTTER COMPLETELY �PER SEC'PION <br />�`/ Jf- % ��"�i =-� �U ��'ii� <br />Approved tor ConSiru n �aie <br />-� , �I% i �� / `:,L <br />FINAL INS ECTION Date <br />�pproved as Cons�ructetl <br />everett PUBLIC WORKS DEPARTMENT <br />� 3200 Cetlar Street <br />Everetl. 1VA 98'Ot <br />Phone'.259��3(l�5 <br />#307 .REI40VE SIDEWALK�CUR6 <br />3.7 0? THE CITY STANDP.RDS. <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Z <br />O <br />� <br />N <br />O <br />a <br />The undeis9i.ed o�aner/npplican� hereUy a9�ec5 to hold dnd s'ave h�mr <br />less ihe City o� Everetl Irom any and all Uaims for Aama9es. cos!s. <br />eapenses, or causes of action ihat may arise because ol installat�on <br />antl mainlenance o� Ihe improvement or other ri9hl�obway use hcieto <br />apPlied for ano luriher a9rees lo remove same upon notice Irom Ihc <br />City and lo replace puAlic pwperry dama9etl lher <br />i . � <br />/j� ��� i� � �,/ f <br />/.-�-,"�//..,''„ �%/�.�, iY�F'!S, <br />�si laaturc m nnn� � / "",y <br />ORK AUTHORIZ � Y THIS PF"' T MUST BE STARTED WITHIN <br />180 DAYS OF T� PERNIT IS �5.�'iED AND THEREAFTER IS 10 <br />BE DILIGENTL PURSUED TO C�MPL =TION. THIS PERAtIT IdA1' BE <br />CANCELLED BY TFfE CITV UPON >NY STOPPnGE OPNJOFiF. �7N THIS <br />PROJ[CT OA'E�7 PO [1„1'S CUf7ATUN <br />