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� <br />� <br />TYPE OR PRINT ONLY <br />P�n �kb� <br />�� <br />,�,w� F« �eie �Q�I 3��j � <br />PUBLIC WORKS PERMIT P„bi�wo,�Pem,n« �i <br />PUBLIC WORKS DEPARTMENT <br />Everett, WA o982018 (425�257-8810 Building Pertnit N i�i "1� �� ' Q�7 <br />TO POSTING � 9 0 ynm public Works FeeS ?O— <br />Meiling Address City Zip pryp�e <br />Applkant Mailinp Address Ci1y Zip p�q�e <br />Describe Proposed Wortc <br />PROJECTADDRESS (if known) <br />Atlach four (4) copies plens lor proposed work • Drew to scale end rqte tha fdlowing il epplicable: <br />• P�operiy lJnes • Outtine and dimenslons of all exisNng antl proposed stnictures on Me lot • Existlng end proposed utilides <br />• CenteAina of sheet • Indicate Norlh • Sh,�w airy proposed greding ehanges • Show measuremeMs <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS: <br />7. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br />2. All work shall be peAormed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800�424-5555. <br />�{' . Connec� ra7�F�=o� rv�o-Ff -�o s�de 5�we,r,� 5�de sewP,,r �s <br />��C� G� � o-� EvU`P� ,� �1 �� 3 � �a01, (a� �' (�04 . <br />W <br />� <br />� <br />� <br />� <br />� <br />0 <br />a <br />ACIiNOWLEppEMENT OF CONDITONS <br />The undenipnetl owrwr/applicent hareby apren lo hdd and save harmless <br />the Ciry ol Everetl hom eny arM ell clahns br dameges, coats, expenses, or <br />causes ot aetlon Ihat may arise because of inatallaMo� end makNenance M Me <br />knprovement a otlier rightof•wey use hereb appllatl fa arq further agrees to <br />remove same upon notice Irom tlie Ciry arM b raplace pWHic PropertY dam• <br />eged Dy. <br />� Dy a ' <br />gnature n i <br />WORK Al1T}pR�D BY THIS PERMIf MUST BE STAflTED WITHIN 1B0 DAYS OF DATE PER�IfT IS ISSUFDMD 7TEF�aF7ER IS TO � DIJOEMLY PURSUED TO <br />CAAdPLETpN. THIS PERMfT MAY BE CAN((.�I11.ED BY T1iE qTY UPON ANY S70PPACaE OF NVFiC ON THS PRO.ECT OVER 90 DAVS IX1RAT10N. <br />