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h7 [>�l � <br />Ax7x <br />G H <br />9HN <br />Y <br />y�i-�i <br />tC C) <br />H :tl <br />� H'i1 <br />UJ H <br />Hx <br />tn O <br />OHd <br />��� <br />4�• C❑� <br />9HL�7 <br />4 <br />t HH <br />8 �' <br />H <br />O❑ C7 V� <br />C�7 � Crs1 <br />HOfyi� <br />� <br />� -- <br />__� <br />oai���5h ' <br />nnnora�io� ro� <br />plJgLiC WORKS <br />Print or Type Only <br />Oesr.nbc PropoSrd Work <br />Prolect AdOress lil knowN <br />I'upxc\Yo�Fal�xrm�lr _Q '`n <br />i.�a.� oeo� . __.�_/_//VCL% % � <br />P E R M I T �,.,,,� �,��,.-. �..�. -- -- <br />r��.� ��� 5 -- <br />i��zs no�� ro�, v:��u S -- <br />o.,�.,�: �� o�,. S --._—: __ .-_ <br />Ci1y <br />ihn9 Atld�ess Cnv <br />Aitach lour IA� copie5 0� Plans lor proposed worA - Dr�v� lo sr.ale anA nol�.�Ce��'erlme ol Shee�rl` �, <br />• Property Lines � Intlicate North <br />• Outlme and dimensions o� au e.�sbng nna • Show any piuposed 9raom9 cnanges <br />pronased structures on the ioi � Si���v measuremenis <br />• ERist�ng and pronosed ulihties — <br />Pi,unc <br />PERMITCONDITIONS <br />t. All calls br inspection shall 6e made 2d hrs. in advance � phone 259•8810. <br />2. All wo�k shall be pedormed in accortlance with ihi, permit and cmrent Cily o� Evere�t Design and Constmction <br />Standards and Specillcations. <br />3. Call Location Untlergrountl Service 4B hrs. telore you dic�. TOLL FREE NUMBER 1•800•424•55 . <br />:, , , <br />. l�= . . � �- < <�- ; � %. ; <br />lor Cansiruction <br />Date <br />FINAL INSP[CTION Dale <br />qpp�ovetl as ConsUucled <br />i•vcrrit PUBLIC WORKS DEPARiMENT <br />� 3200CedarSimet <br />EvcreU. WA 9R201 <br />Phone::S9�B810 <br />��� <br />,�s � <br />, , ,� <br />.; _ <br />W <br />� <br />�w <br />_ I <br />W <br />O�\ <br />♦ <br />Z <br />O <br />F- <br />N <br />O <br />a <br />ACKN0�1'LED;iE�7ENT GF CONDITIONS <br />Tne unAersi9ned owner/apP���c�u�� ��meUy anrees �o hold and Save hnmr <br />Ies: t��e Gty ot Everetl fiom ;iny and ail claims lor Aama9es. costs. <br />expenses. or wuses of action Ihal may anse Uecouse ol ins�allaiiDn <br />and ��+aintenanre ol the improvemenl or othr nght-o��weY ��s�� herelo <br />appDetl for and Iwiher a9ree5 t0 ieinove 5sme upon natice irom �he <br />City and Io replace pubhc propeit)' dama9ed thereby. <br />D.��v <br />Si9natmc ol APPlicant <br />80PDAYSTOF DATE PERM1IIT ISCISSUED AND TH[REAFT�ERv15'{TO <br />BE DILIG[NTLY PURSUED TO COMPLE710N. THIS P6RMIT tdAV B[ <br />CANCHL�ED BY THE CITY UPON AN1' STOPPAGB OF INOAK ON iH15 <br />PF70JECT OVER 90 DP.YS DURA710N. <br />