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Date�L-22 <br />Ap0liWtion For <br />pUBLIC WORKS PERMIT <br />PrinlorTypeOnly TO POSTING_�_-�3-�s <br />M-3�-z9-q- a � <br />Iweucwm�.>umn. _/Z�� <br />eme oeo� • 36180 _ <br />�e�,<wa,,,�., s <br />.�,.� �.. <br />�rxnoo�reev.�a 5 <br />B.a=�eD�e S 2�� <br />�4C�Li�.�.rn5 �r�zc-oPF.N. i o00— <br />659-0355 Don�or�c 1�^� <br />Don 6 Jo Lecin 1723 Colbv Ave Evere[t 98201 ?52-G374 home <br />Owner MailingAtltlress Cdy up P�one <br />Wner <br />qnPp�g�� Mai0n4 Atltltess C�IV Zip Phone <br />Desc�i�o Pro�osetl \Yo�k <br />Pmject AtlEiesslil known) � <br />1� �12U2' I l' <br />AII•lc� IOW (4� COp�eS O� p�d0510� piOpOSCE work � Draw 10 Sc.11e .lntl note iM1e I011owinq d5 BpphCd�l¢ <br />• Piape�ly Lines • Center6no nl :Ireel <br />• Outl�ne and aimensmns ol au rrisling and • Indiwte Nat� ' <br />pmpOsea siru:iwes on I�e lol • S�ow. ny 0�)posetl p�aamg c��n9es <br />• E�isl�np anC pmposed itillires • S�ow measu•emenls � <br />00 NCi <br />PERMIT CONDITIONS <br />t. au cans lor insoeclion shan oe maCe 2a hrs. in ativanca � pnone 259•8870. <br />2. All work shall be pedormeJ in occortlanco wilh I�is permil enC cwrenl Ciry ol Eerell Desiqn entl Lonsiruction <br />SlanCnrtlsandSpacilicalions � . . <br />3. Cell Location UntlorOmuntl Sarvica 4B hrs. belorn you dig. TOLL FREE NUMBEP 1•800�4245555. <br />9, A 5��-�' �j�j���zvc d� la� C�a �ed /l—l7— 88 <br />5��, r+r �i,v� �own s��-fs � drA-�ew� clra/k�..� <br />(a n7ec�ro�c � � � s-�a l� -f-1,.,o�,r%/� w�b � <br />� � b�d � 319 <br />i <br />�1 � � <br />Dotc <br />APP�ovod as Gor slmctetl <br />�PUBLICWORNSDEPARTMENT <br />9200 Ccdar S�rcel <br />Everell. WA 98201 <br />Pnone :59+�Nw <br />OF CONDITIONS <br />W <br />� <br />� <br />Z <br />O <br />� <br />O <br />a <br />T�e undeisi9netl ownei/applicanl �ereby nB�ees lo �attl ac� save harm� <br />less Ino Cdy o� Everetl tmm any an[I all claims lor tlamnyes. cosis <br />o� penses. ar cnusas ol aclion Ihat may anse becauso ol :nstnllabon <br />and mamtewnce ol t�e imp�ovement or at�er ng�Pol�way use �ereto <br />applietl lor dnd luilhe! aqrCCS to �emOve 5am0 upOn nolice IrOm �he <br />Ctly and to re0��co Oublic pmperty �ama9etl I�ereby. <br />\,r l��->-�-- � �q �1? <br />Signalu c ol fippllcant Dal . <br />WORK U7MORI2ED BV THI$ PERI7IT Ml1ST BE STARTED WI7MIN <br />180 DA 5 OF �ATE P[Rh11T IS ISSUED AND THEREAFTER IS TO <br />�E DILIGHNTLY FUPSUED TO COhIPLETION. THIS PERIdIT AtnY 6E <br />CFNCLL�[D B Y TI�[ CITV UPON ANY S'�OPPAGE OF \VC��4 Oq iIUS <br />PROJECI OVER np pAYS JUFNTION <br />