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� � � <br /> c � H <br /> 9Hxti <br /> Hz F+ r- „ . . .. ,� .:�'1 .'.. l;.,;; l,,,,, � - 15 ; . � <br /> � � � PuE�m Wo�ks Parmil��_Ls2=1 <br /> � �� Date�./I�{�d <br /> Ola9 oeo�.� <br /> y Applicaliun For _ <br /> � y � PUBLIC WORKS PERMIT PuOToaFacPoe $ _ <br /> Q� H lussFpPl.Fe�r Paia 5��-�— <br /> � U— U!/ <br /> H lTl O ea�,���o�� S -- <br /> r�i� � Prinl orType Only <br /> H <br /> zH <br /> � H y � ' � � � _ 'I p� �, / Y:3"�O l d S�'�-.�7�-/h — <br /> � y _ Ll6 � c7�1 �- 7ii!`�JTr/� ��/D///7" ahone <br /> ~ Owner MaiNng A ress ��Y z p <br /> C'� C7 V� <br /> �� � J 2V�^^ �i� Phone <br /> H O f/� Applicant Mading :tldress City �t <br /> /�l rJ/.�� h� I �i l✓ Gtv,� ---- <br /> Describe Proposed Work �' �--- <br /> � <br /> � _ �! S� f ' � <br /> Prolect Address(il known) <br /> e <br /> Atlach four(4) copies ol plans lor proposed work- Draw to scale antl note ihe lollowinn as applicable: � <br />'. • PropeCy Lines • Centerline o: streel <br /> ! O�tline and dimensions of all existing and • Indicate North <br /> proposed struc�wes on the lot • Show any proposed qrading changes <br /> • Exis�ing and proposed utilities • Show measurements � <br /> j���; �O NOT WRITE BELOW THIS LINE O <br /> �� <br /> � PERMIT CONDITIONS <br /> 1 I � <br /> 1.All calls for inspeclion shall be made 24 hrs.in advance-phone 259•5810. <br /> �_ � 2.All work shall be pedormed in accordance with ihis permit and curtent City of Everett Design and Construction <br /> � � Standards and Specilications. a <br /> �st 3.Call Location Underground Service 48 hrs.Gelore you dig.TOLL FREE NUMBER 1-500•424-5555. � <br /> � ✓� / -�if c%rsz.a- �. �oCa,�C' c-��-�ii.c% � <br /> , ll",vl�"�n� � ��a�?e��/ _ d <br /> I `�.� _ �>�'� �,'!� �li7a/'�(' .G7`' CY.G�l�� '�' �4/t�9-G �/-t'�i�=% <br /> LGC-� � u �y `i � <br /> ✓ �.,,y=�,� ��a�.�i .. ✓i� Cc�y m,`' �C�lizc� c�a-ea �Jza7` V♦ <br /> w�r� �'6?zCYiYCPi ���a.�.avr,�y O�v �:� qc//�/ �'IO/Lc2� .�c", <br /> l/ �� � <br /> fjj/L�'vL' ��U f�✓'��., <br /> __ <br /> ` a <br /> ; <br /> �t � — AGI<PJO:"lLED�EMENTOFCONDITIONS �i <br /> +�0�� 7hc undersigned owneriappiicant hereby ag�ees te hold and save haim- <br /> less the Cily ol Hverelt Irom an7 and all claims lor damayes. costs, <br /> � � / expenses, or causes of action ihat may arise 6ecause ot installation <br /> /��'• j��� /�-_' � and maintenance of the irt�pro��ement or other righFoFway use hereto <br /> `��{1 j/t f -�-����- applied loi and Wriher a9rees to remove same upon notir,e Irom the <br /> Approved for Const� elion i L°'� City and to replace public properry damaged Ihereby. � <br /> e�, ��°ll� �-� ' �� _ . +C,. �!!� ' ` / � 2�/ -"/J <br /> FINAL INSPECTION Date - - . �� "'� Date <br /> Approvetl as Constructed �Sig alure of Applicant <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> e�� Pi1BLIGWORKSDEPARTMENT 180 DAYS OF DATF PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Sireet BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everelt.WA 98201 CANCEILED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�8810 PROJECT OVER 90 DAY'S DURATION. <br /> .—� <br /> ' .� _ ... .,. .. � . <br />.. . ..;r . ;, ::� .,-• � ...-._ . . ,......, . ,...: . � . _. <br /> . .,.' f :.� � ��.�.:.� . .. - .x... ... � _. , ._.. �';�.,, . ' ,.c:",.� .�. . ._ , .. <br />