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l'J � � <br />A � W <br />C, H <br />9 H tA <br />4 <br />K � n <br />H �I <br />'�1 H '�I <br />fn H <br />�O� <br />�3 <br />OH <br />H�8 <br />� V �] <br />Y��-3� <br />y <br />HH <br />� <br />C7 C fA <br />� � C�1 <br />HO[yi� <br />L� <br />� <br />I �� <br />! �, <br />aU:. <br />Date �� � i <br />rn <br />PU'BLIC <br />l] <br />•-,j <br />Applicalion Fur <br />WORI�S PERMIT <br />". n r:, .�,n r n �,: <br />Print or Type Only �`; � 9"; �' '• <br />�. n. u'l o� u:F t� o <br />.�j O� [� [� �l T L7 <br />bi x� �'T M e'� �� <br />�Y . _ �N +f�. <br />Applicant <br />C'] V' S _- i�: - <br />c:] uw [.] : [n 1-- <br />J J W J [1 <br />i�] [i L 1 Cv V <br />i � <br />.r U <br />�� i <br />ti t� <br />TO POSTING_. <br />MnllingAdtlress Cm; <br />Descn6e ProPosed Work `��-�«"�UC f�L�v �- r�l__ <br />Projecl Atldress Id known� <br />P�til¢ 1\'a�b Parmil • � G J� -. <br />�����a u�,�� . '3 535 <br />89 - `---- <br />PuO'iCWO'F9�e0 5 <br />lO1TlFl1! <br />1e25 PpO� Fro Vaul 5 <br />g%0o <br />e na�_e o�i. 5 . <br />Zip Phone. <br />Attach bur (A� copies ol plans for pwposed wo�k - Draw to scalc and no�e ihe followiny a5 apphGnble. <br />• Property Lines • Centerlme ol strcet <br />• Outlme a�d dimenslons o� all ezistinq anA • Intlicate Nonh <br />proposed simcWres on the lot • Shov: any proposeA 9�atlinq chan9es <br />•[zisling antl pwposed ulilities • SP,ow measwumenis <br />PERMIT CONDITIONS <br />t. All calls for inspection shall be mede 24 hrs. m adv. nce- pho�e 259•8810. <br />2. All work shall be penormed in aCcordance with Ihis permit antl cunent City ot Everett Des��7n and Conslruction <br />Standards antl Speufications. <br />3. Call Location Underground Service 48 hrs. belore you tlic�. TOLL FREE Nt1MBER 1•800-424•5555. <br />� �1��o LG�C/I'.0 � .S'�/':'G�� �//l7�iY�i�.'in.�ni.S <br />f�:'r ��4n qfJ 7�'Otic 0� !Jl/ 7`fl� f�v�ili c- <br />:�%% S ..Z.3-/ � ����ri 4.TN«'Grl1 I <br />`_—� <br />����_��� •s/�,' .�-P <br />ApprovGtl for Consl ctio �ate <br />� � ;��� /— �-�r-; l <br />fINAL INSPECTION Dale <br />Ann���ed as Consirucled <br />rvrirl� PUBLIC WORKS DEPARTMENT <br />� 3200CedarStreet <br />Everett. WA 9B201 <br />Pnonc: 253�f61U <br />�J � .'�On d <br />/�����_f : �',Jf <br />AChNOWIEDGEMENT OF CONDffIONS <br />W <br />� <br />_ / <br />Z <br />O <br />rw <br />_ / <br />� <br />a <br />Thc undeisi9ned owner/appliwn� hereby a9rees to hold and save hann- <br />les:�. ihe Gty ol Evereli Irom nny Flntl all elaims for Aamages. costs. <br />ecpenses. or causes ot acGon It;.: may arise Uecause ol install�;�on <br />and maintenance ol ihe imyrovemenl or other nghPof�way use heioto <br />applied lo� and lurther .+.grees to remove same upon nolice Irom Ihc <br />Cily antl to replace W�� Property a�aged IhereF <br />/�`��p�- �=� � 3 -/-`JI <br />1 � `` < < <br />Siunaturc ol Applicant �� ��' <br />1VORK AUTHORIZED BV THIS PERAIR MUST RE STARTED \NITb1l'd <br />180 DAYS OF DA7E PERMR IS ISSUED AND TNEREAPTER IS 7p <br />BE DILIGF'J71 Y pURSUED TO COM1IPLETION. THIS PERh11T A14Y OE <br />CANCEL' ED BY THE GTV UFON A�JY STOPPAGE OF ll'ORK ON TH'S <br />PROJr�.Ci O'✓EI� 90 �AYS DU�'��TIOf7. <br />