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� __. . ._._ .. ._ _ ___. <br /> �' �I <br /> ___ __ _ ._. _ . __ blPy .._�.--�- � " ..��� —�..__ -.�.� .. .� <br /> /f <br /> �, � �y � �Ut11�[WO�hGVClm�l• <br /> l <br /> Date e��a oeo� • — ",� <br /> � ALnlicatio� For __ <br /> PUBLIC WORKS PERMIT °°°"`"'°'"„°° <br /> ,o�.��PP s <br /> ��� I LrsaAoni Vro Pau1 5— � <br /> Aaunc.Dun S <br /> ,p�s ' Print or Type Only <br /> 9Hf~i� <br /> H �� , � .' J. . ' . . . _ � - , . . <br /> fC f'] ', MailinJ�����ss City 2iP Phonc . <br /> y.� i Owncr <br /> "i7 H"� �i <br /> NH[' <br /> x .'Z 3 �� qpplicant MaJiny Adrfress Ciiy Zin Phonc <br /> C1 pCi7 I <br /> HC <br /> :U �C7 �' �escribe ProPosetl\Naik / . <br /> 0 � _-_ <br /> (i]V � <br /> H � <br /> z �� � W <br /> � �y � I <br /> � ty y �.. P�oler.l Address I�f kuownl ! .' . . . . � !.. � <br /> � 5 � <br /> �'+C� � Attach tour 1�I copies ot nlans�or pmnosetl work- Draw to scale antl note Ihe lollowing as applicable: � <br /> y y y ' • Property Lmes • Cenledme o�slreet <br /> H O ti i • Outiine and dimensions ol all existing and • Indicate Nonh <br /> proposed siructures on Ihc lot • Shmv,ny propusetl yradm9 ch;inges <br /> � • Ea�slln d pioposed ublities • Show measuremenis M <br /> 9" W <br /> . DO NGT WRITE BELOW THIS LWE O <br /> �. PEfiM11CONDITIONS � <br /> 1.All calls lor insped�on shall be made 24 hrs.in advance-phone 259•8810. <br /> .,,. � 2.All work shali be pedormed in acwrdance with this permit and current Cily ot Everett Design antl Construchon <br /> � � � StandardsandSpecHications. <br /> '� � 3.Call Location Undergwund Service 48 hrs.belore you tlig.TOLL FREE NUMBER 1•800•4243555. �) <br /> G <br /> '« y' � . . . . � . O <br /> � � <br /> �� li ��/w) I <br /> _/ <br /> �_ � <br /> .�� � � <br /> i � <br /> i <br /> � `��' <br /> � ACKNOVJLEDG[G'[NT OF CONDITIONS '� <br /> ' `� � The undersicnetl owneVapPLcam hcreUy a9r�es to ho�tl and saoe ham�� <br /> �'' � - less Ihe Gty of Everen Irom any antl all claims lur dainages, c:�,t:, <br /> ' I expenses. or ca�s s ol act�on Ihat may anse �ecause ol instaliation i <br /> and mam�enance o� t6e improveme�nl or o�her nghPobwap use heieta <br /> ❑pplietl for and hrtlhei n9iecs Io �emove same upo�� ������e �rom thr <br /> • �, ApprweA lor Conslruction Date ���y�nA to replace pubhc U«Perty Aama9ed thereUy. I <br /> I <br /> � FINAL INSPECTION ��1e �''�`' I', <br /> � Appwvetl as ConsUucted Siqn,ture O�AppliCent <br /> WORK AUTHORIZ[D �V THIS P[FMII MUST BE STARTLD W:THIN i <br /> � rv�vrll PUBLICWOHK;�D[PAaT'd[NT 1P0 DAYS OF DATL PERId1T IS ISSU6D AND TH[AEAFTEH IS TG <br /> � 3200 Cedar Streel BE DILIGLNTLY PURSUED TO COh1PL[TION. THIS PERMR fdAV BE <br /> Evcrett.W�987.01 CANCELLED BV THE CITY UPON 4NY STOPPAGE OF N'ORK i1N T��IS li <br /> Plione:259�eB10 PROJECT OV[H 90 DAVS DURA710�! <br />