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IFl� <br />� <br />���� '� `4. i��,. tC <br />,. . . r _ ' ' . . . . .. - � . <br />. . -' \e;9'ri�?-� �, - . - ' � � . �� �,' <br />To resTiNc � -_ <br />� �2� <br />�8t@ 9'25-9I C�'�31-Z�_C PoblicWorFSPermil• <br />v. J 91�2%% % <br />Appllcalion For � � , ; _ ; „� _ ,,.,� eiaa� Dea�. a __ <br />, j. , � <br />PUBLIC WORKS P�RMIT = _. °�°To °FeFee : _ <br />� <br />� �e!! �DP� Fa! Pe1E i <br />� U b P � C�) L7 C� If) B61enc. �. $�0 <br />Print or Type Only �_ , . — <br />`i �no�3o or^�r.i <br />r; <br />r•? t�-• r m m r..i r, . tin . <br />V] M tll H ryt� Q] �U <br />� [�. � U � M <br />�WfIBf <br />Omni Construction <br />Clly <br />Deecribe Propoaed Work New construction SFR <br />up rnonn <br />G] <br />W <br />'S_ <br />" 334-0935 <br />Zip Phona <br />Project Atldress �ii known) <br />Attech lour (4) copies of D�ens for preposed work • Draw to scale and note the following as applicable: <br />• Property Lines • Centerline oi street <br />• Oulline antl dimensions of all existing and • Indlcate North <br />proposetl slructures on the Iol • Show any proposed grading changes <br />• ExistinB end proposed utilities • Show measuramenis <br />PERMIT CONDITIONS <br />1. All calls for inspectlon shell be mede 24 hrs. in edvance - phone 259-8810. <br />2. All work shell be pedormed in accordance with this permit and current City of Everett Design and Constmction <br />Stenderds end Speclficatlons. <br />3. Call Locatlon Underpround Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424•5555. <br />� �(�I� � ll ln-c. Cic�� s�G��S �C-n s,de 5ec..�,/. <br />s. �dwc. G�✓'�-t. w.c+�y -Frv�,-� p� opP� ti nC �v c�d�¢ �jj-'li..<riwv� <br />u � u � <br />�1n 12; �bc� �uitJw.vJ . <br />�o. � x�sk.��� wa-i.er �;nz ��31(� G�'a�d Slna�l (ae. �L.:l:zed <br />-�,� �13i2� C-,ra+�� a,..� d✓ie� ��la� �v l te sha l l 4�e, <br />;�, ��t� �(e.d �h s tior} }' �at �-E. � 1��ea�z w•o,.�.� t� <br />'�',31�0 �;'u�+M�Jr.� c.`oPl� ca.,.,�-s e•x <br />� <br />O _ (� -1 <br />Date <br />FINAL INSPECTION <br />ApP�ovetl as Consiruclod <br />9A�PUBLIC WORKS DEPARTMENT <br />3200 Cetler Sireel <br />Evorett, WA 98201 <br />Phone:259�8810 <br />W <br />H <br />� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby a9ree5 to hold and save harm- <br />less the City ol EvereU from any and all claims lor damages, costs, <br />ezpenses, or causes o� action lhnt may arise because of installation <br />and maintenance ol Ihe improvemenl or othrr ric�ht�ol-way use hereto <br />applied br and lurther agrees 10 remove same upon notice Irom Ihe <br />City and to replace public property damac�ed thereby, <br />� U I�la.inn n A I�'a.5 -q 1 <br />Signalure ol Applicant Date <br />WORI( AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />780 DAVS OF DATE PERMIT IS ISSUE� AND TNEREAFTER IS 10 <br />k3E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT A1AY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />A <br />P <br />� <br />� <br />r <br />� <br />