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� <br /> � PUBLIC WORKS PERMIT <br /> oe�a_ �J l .z � �4 � � <br /> PUBLIC WORKS DEPARTMENT Publk Works Permit N T T �� <br /> 3200 Cedar Street <br /> Everett.WA 98201 259-8870 <br /> Builtlirq Permit M <br /> TYPE OR PRINT ONLY <br /> PuWfc Works Fee S • <br /> T' <br /> /rJ"l�n �� 5��� � ` , � ' <br /> ��a�. SJ�� [, � i �i�; �I,C�.?�� C <br /> Owner Mai6ngAddress � � �� <br /> ��ty Z�P Phune <br /> Applicant Mailing Addreu <br /> City ZIP Phone <br /> Describe Pro�osed Wprk � , � i��� <br /> �. // ' W <br /> �- <br /> - <br /> PROJECT ADDRESS(if known) . � � � ' -f' ,, � <br /> Attach tour(4)copies of plans(or proposed work-DMw to scale and note the following H appliwble: m <br /> �Property Lines 'Outline and dimensions of all ezisting and proposed structures on the lot �Exisling antl proposetl Wilities O � <br /> •Centerline of stme( •Intlicate Nohh 5how any proposed gratling changes 5how measurements <br /> DO NOT WRITE BF_LOW THIS LINE � <br /> PERMIT CONDITIONS: <br /> 7.All calls for inspection shall be made 24 hours in advance-phone 259-8810. � <br /> 2.All work shall be performed in accordance with this pertnit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-600-424-5555. <br /> � <br /> � <br /> O <br /> a <br /> 0 � � � �� <br /> MAY 0 81997 <br /> .................................... <br /> CITY OF EVtRETT <br /> OuIICin� Divlsion <br /> Q� �.� />e.�ur"S G- <br /> ACKNOWLED3EMENT OF CONDIT70NS <br /> � The undersigned owneNapplicant hereby agmes to hold end save hartnless <br /> � yJ the Gty ol Everetl from eny and all claims for damagas,costs,expenses,or <br /> Approve oi Construct' ate causes oi action that may arise because of installatbn and maintenance of <br /> the Improvement or other rightof-way use hereto applied for and further apiees <br /> /� to remove same upon notice from the Cky and to replace pu6lic prp�erty <br /> [ �.. �� �Z_ damaged theieby. <br /> FIN SPECT70N Date �r <br /> Appmved as Constructed �/y� ;'�/ �� <br /> �� ' "/ <br /> ature of I' Date <br /> WORK AUTHORIZED BY 7HIS PERMIT MUST BE STARTED Vy�7}{IN 180 DAYS OF DA�E pERMR IS ISSUED AND THER R IS TO BE DIUOENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY iHE CI7Y UPON ANV STOPPAGE OF WORK ON THIS PR0.IECT OVER 90 ppYS WMT1pN, <br />