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<br /> /lopl'ca� tion For e�aa oea�r 11��L.--�•'�— �v "'f,�; -t�s L; �
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<br /> RI�BLIC �V��KS PERf�!lliT OUEIICWorkaFee -,1,, �,.� -
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<br /> Describe Arcposed 6Vork ��C� S!�/�rYJl /��D,S/('i��ff(�,CJ .. ':`� ~ � w:'�= _.,�'���,:
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<br /> Atta�h fcur(4) co� oa f plana for proposed work- Drax�to scale and note e-ollowino as opplicable: � .� ,� � a *w«' _
<br /> • Property L eni s'� • Centerline of street � "�`� � .� -,�i'' � '
<br /> • Outline and dimensinns of all existing and • Indicate North .
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<br /> proposed structures on the Ipt • Shcw any proposed grading changes �}, �'a
<br /> • Existing and pioposed utilities • Show measurements - ��� ���µ��� �'� �
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<br /> DO NOT WRITE BELOW THIS LINE � . '�, ,-
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<br /> PERMIT CONDITICNS $ `�L
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<br /> 1. PII calls for inspection shall be made 24 hrs in advance• phcne 259•881 5. y
<br /> 2. All work shall be perfo.med in accordance with this permit and current City of Everett Design and Construction � �, `"tti;Gd,.` '� ����`��
<br /> Standarde and Sper,ifications � •�tyjay .�4 ��
<br /> 3. Call Location Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800•424•5555. �. ,�rti,y, '. "�'"��
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<br /> ACKNO'NLEDGEMENTOFCONDITIONS � �,1_ �'_��� ����.,�, n;
<br /> The unders?gned owner/applicant nereby agrees to hold and save harm� '�.�3 � 'i,�i��f;a ,�.���M�
<br /> less ihe City of Everett trom any and all claims for damages, co.ts, �� `�e � �
<br /> expenses, or causes of action that may arise because ot installation `�"�'�`'��
<br /> �—(��� and maintenance of e improvement or other right•ohvray use hereto ��� . �. �� � �
<br /> lied for and tu er agrees to remove same upon notice (rom ihe � 'r����t�� �� ��:��
<br /> pproved for Construction ate Cit and to re ac publ' perty damaged ther y. �;�� ,'�y� ,�)
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<br /> AL I SPECTION Date �
<br /> pproved as Constructe� nature f Applicam Date � � � .
<br /> everett PUBLIC WORKS DEPARTMENT ORK AUTHORIZED BY THIS PERMIT MUST BE STAPTED WiTHIN �
<br /> 3200 Cedar Street BO DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO
<br /> � Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. iHIS PERMIT M�y gE , .
<br /> Phone: 259-8875 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WOHK ON THIS i
<br /> PROJECT OVEA 90 DAYS DURATION. � � ,.
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