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..;, r�:n'�{:h4A4.»a?'e'a�* �. <br />—� _. _. �'�".�� {�l'�. <br />..la � � y�w,. <br />Y.'v <br />Date�'� <br />Application For <br />Pl1BLIC WC?R:".S PEEiM1T <br />Prnt or Type On';y <br />Mailing <br />Applicant <br />Describe Proposed WorF /v e�l) Iif <br />Address <br />ldry <br />Zip <br />Project Address (if known) � � "�'-`-'�` "- -- <br />Aqach tour (41 copies of plans !or proposed v.�or6 � Draw to scale and note the lollowing as applicable: <br />• Propeiry Lines <br />• Outline and dimension> ol all exi�tiny and <br />proposed structures oi: ihe lot <br />• ExiSting and propOsed utilities <br />£'-9-33c� <br />P��ULc Wa�ks Pmmi�� �vp .. <br />Bina. DeGt . _�L���_. <br />Publ¢ Wo�xs Fce <br />TD�aI FCB 5 — <br />:ess Ano�� �rr P.uO $ <br />I?alanc,.Ov�. $ ��� <br />• Centerline of street <br />• Indiczte Norih <br />• Shovi any prop�s2d grading Ghanges <br />• Show measurements <br />ne <br />rnune <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance • phone 259•8811J. <br />2. All work shall be pedormed in accordance with this permit and current Ciry of Everett Design and Construction <br />Standards and Specificalions. <br />3. Call Location Underground Service 48 hrs. 6ebre you dig. TOLL FREE NUAABER 1-800-424-5555. <br />ACKNOWLE�GEA4ENT OF CONDITIONS <br />� <br />O <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />les� Ihe City of Everett Irom any and all claims for damages, costs. <br />expenses, or causes o� action lhat may arise because of installation <br />G��')� p,-��. �?�' and maintenance ol ihe improvement or other right-ol�way use hereto <br />c applied for and further agrees lo remove same upon notice irom ihe <br />o❑ _ Date Cit an to replzce publ�roperty dama9ed thereby. <br />✓fV .�lil��G�` p�-oZ(o-/rU <br />FINAL INSF'ECTION Da�e <br />Appreved as Construcled <br />everett PUBLIC WORKS DEPARTPAENT <br />� 3:00 Cedar Street <br />Everett. WA 98201 <br />Phone:259-8870 <br />Signat ire of Applioant "�'� <br />WOR AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 AYS OF DATE PERt�iIT IS ISSIIED AND THEREAFTER IS TO <br />8 DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY TI1E CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />