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�: : .�� �/ <br />. <br />� <br />�: <br />� <br />Print or Type Only� <br />N <br />Applicetlon For <br />WORKS PERMIT <br />wa��won�.w,mn. '�,2� <br />ewv. o.o�.• <br />r��eiK won. v« s <br />Tot�l Fse <br />la�� bG� Fss P�IC i� <br />�IlMI �Y! s Ll�. <br />�S2-y�3 <br />� • ►��/�I'� <br />,_ : • <br />C /� /�: i' � ii! ♦ _ _ � 1 I � • <br />Prolec� Address (il known) <br />Attaeh four (4) copies ol plans tor p�oposed work • Draw to scele and note the following as applicable: <br />• Propeny Lines • Centerline ol sireet <br />• Outline end dimensions of all existinq and • Indicate North <br />proposed structures on the lot • Show any proposed 9rading changes <br />• Exlsting and proposed utilities • Show measurements <br />PERMIT CONDITIONS <br />1. All calls for Inepection shell be mede 24 hrs. in advAnce • phone 259-8810. <br />2. All work shell be Derfo�med in accordence with ihis permit and current City of Everett Design and Conatructlon <br />Stenderds end Specifications <br />3. Cell Locetlon Underground 5ervice 48 hrs. before you dig. TOLL FNEE NUMBER 1-800�4245555. <br />� <br />Approved as Constructed <br />everett PUBLIC WORKS DEPARTMENT <br />� 3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259•8810 <br />3 — `� <br />Date <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />� <br />O <br />� <br />� <br />� <br />a <br />The undersigned owner/epplicant hereby agrees to hold and eave herm• <br />Ie55 the Cily of EVefett trom eny and ell Cleime for tlemage0. G06t0. <br />expenses, or causes ol aclion thet mey arise becau6e of inatall�tlon <br />and m�intenance ol the improvement or otAer ng�t•of•wey uae hereto <br />epplied for und further agrees to remove same upon noticn frcm ths <br />City and to replace public property damaged thereby. <br />WORK AUTHORI7E� BY THIS PERMIT MUST BE STPRTEU WITHIN <br />180 DAVS OF DATI° PERIdIT I$ ISSUED ANO THEREAFTER IS TO <br />BE DILIGENTLY PURCUED TO CQMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY fHE G!TV UPON AN'/ STOPPA6E OF WORK ON THIS <br />PROJECT OVER 90 DAVS DURATION. <br />