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��� <br />. ,,�...•.�_. — — — -- <br /> .,.�. . <br /> ��_ � <br />��:i'"�'° <br /> s��a:;�;,<:s, <br /> _:,���:,.x <br /> : .y;:,,� <br /> v,:;�.��x` <br /> ��:: <br />���� , <br /> �r,X. <br />�-*��� <br /> �• <br />_:.� �' ,:.� <br />; .�.,�:�".. ; <br />:r% �� i <br /> �v` '`�'�'' Appiication For <br />`x �� � ' ���� PUBLIC WORKS PERMIT °ate_�7�6 <br /> �ih� <br /> k � As�� <br /> !� �'" �+9fi' PUBLIC WORKS DEPARTMENT Public Works Permit# <br /> a <br /> ;�' � ; 32CJ Cedar Street J <br /> Everett \Ni\98201 259- 10 9� Q <br />�� �-�"� �.; '�;TI�IG �" 2 � ,s9� �# . <br /> i{ ��� �� TYPE OR PRINT ONLY Public Works Fee 5 �p �O <br /> _i� �� <br /> 6�� �� Gr+rz�( a�es�e�Sc�N �s� ��•-' �� s� �,.e��f, w�a �s�l 33� � �s�s <br /> �� �.. �7 Owner ^ Maili�g Address City Zip Phone <br />-�� y�� in��. i'NC7t4�'r �'^i^('�� p <br /> ,��,i Pwr�ln r�—+e.v-.—P 1��zG1 GKv-z-.-�cJ. �'�. �'�.ae.ie�, �ib��o 1 � ��' ' !o� �� <br /> '�'•�.`�``'s� Applican MailingAtldress Ciry Zip Phone <br /> y� �a <br /> u '�' / <br /> Describe Proposed Work � ' � � /✓��"� ���� �/"U+ �''� r v-��✓ o <br /> �� :.. ���cs-2 � �o�r� ��� r— � <br /> T( y <br /> �°� � �nvr� D��-.�p��—r ��/� <br /> �, , � ' .c�. ,�,-'� V r <br /> `" � r r b 3'7 c�✓`e�' <br /> ; PROJECT ADDRESS (if kno�,vn) � <br />' 4 a <br /> Attach four(4)r.opies of olans for proposed work-Draw to scale and note the following If applicable: <br /> .� �4���Ff. •Property Lines •Outline and dimensions of all exis�ing and proposed structures on the lot •Existing and proposed utilities <br /> t'� ` •Centerline of street •Indicate North •Show any proposed grading changes •Show measurements <br />� ,1,� : � '� <br />�, �, k' 1 DO NOT WRITE BELOW THIS LINE � <br />"� '�'f PERMIT CONCITIO�S: <br /> ix;r� � a 1. All calls for inspection shall be made 24 hours in advance- phone 259-8810. <br /> }*^`'.i p`.i 2. All work shall be performed in accordance with this permit and current City of Everett Design and � <br /> `'�"�`� � Construction Standards ard Specifications. <br />��, ,N` y� 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br />+�C�" ,°; �' ♦/� <br /> � 2:; 7.� �e� C%�j/ S�i�Zfs C�a�i �� vL� �rnes V♦ <br /> 4 � <br /> � � _ <br />µ+ � J�. C�Gf c.� Lvrf�i /�S�peC�r ,BK�'oi-� Car/cri� t� � a <br /> 4��� x / �[ J � <br /> 1� � � (_.�Je� �/�h S//'CG�T �/�7� � / 1 ' <br /> 4 i / / 1 / f'C�i'l rC�"�^S �1 D/�c L% �/P <br /> y� `r'� /il.s/�hL�47i</� � � / / <br />� � <br /> ka ��+� �S 09/18/9610:14NMOOOAH771' k:t::-K <br />;� a 4 / >. <br /> � . .d <br />$ : '� �, ' ; H000%3k0 <br /> 4 ;�� ;;��:; OTHER 9.z0.OD <br /> i "g 16'� CHECI; S^c0.00 <br /> ; � d <br /> S<�4�' a <br /> �, � � "`� <br /> t * '� <br />� 1� ii�I-t� � ACKNOWLEDGEMENTOFCONDITIONS <br /> The undersigned owne;/applicaM hereby ayrees to hold and save h�rrr�less <br /> � N . 9 �8 ihe Ci�y of Everett from any and all daims for damages,cosis,ezpensec,or <br /> Approved for nsf on Dat causes of aciion that may arise because of installation and maintenanca of <br /> ,, �� j lheimprovementorotherright-of-wayuseheretoappliedtorandfudheraqrees <br /> � to rema;e same upon notice (rom ihe Ciry and to replace pu6lic property <br /> l�- _ � �' damagedthereb}�. 'I <br /> FINAL S CTI N Date ��� �' <br /> Approved as Constructed � I I G � / <br /> o �,( <br /> � nature of Appliwnt Date <br /> WORK AUTHORIZED BY TiiIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLE�J BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRC�JECT OVER 90 DAYS DURATION. <br />...• I <br /> ,,._,..:.�. -- , �� . . - - - - � <br />