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�� o �, <br /> � n <br /> T H <br /> a� zx <br /> � y�y � / <br /> � ^ � , ry ,'��-;4 � J - 3�- <'9-S I `�� - 388 <br /> y � �u:�i.c Wo�',s Permn• / " <br /> Date /n' /J : � < �l•. ��-� <br /> tl H x �C ' LL.—. <br /> om3.neo�.• <br /> y H �� ApAi'ralion For ___ _ <br /> p7+� r��'f�IC '�VC)RKST�����—� PuCi�cWorksfea $ —_ <br /> o ��, Colz Z. z o�o�F�e <br /> F] d u �es�Ap01 Fee'aie $�— <br /> �7 � o o c� c� n n o -, n r.� a.,m�cw ou� S ��� <br /> OH , <br /> la LCT. O r in o o r- �,: o c, u r.� c i ----- ---- <br /> H„ n Print or Type O�ly� r o o .+�- o � � �^ � <br /> �o m .. .-+ m r.l IA r, .-� Ol <br /> �/]W H tN UI � 4i !TJ �V <br /> jq W M <br /> �" H y �-' � , , � % , /�' '��--�-�'_�1��c�i'YIG� '�J �.�C,'-- <br /> O C/� H � � �,� I�de�Fi�FA � . �i r� i �� CitY 2iP � P!�one <br /> Owner �� p cn rn x _s� � � w �" �-' <br /> .n fj c] ui U "" UJ � rJ 1-� U .3 l� W <br /> �] fJ �/J \ p �_i J J (r' � •J O UJ ti S <br /> � TJ 3F �:.i � � G_ u O -.• Sc ti) ti C] ��"� <br /> � �7�- � J- <br /> � y � �.pplicanl MailingAddrrss City Zip Phone <br /> HOtn <br /> Describe Prcposed Worh � ,����' ��'� �- -- <br /> ____ — -- � <br /> '_ 1� 7� ^ �{'(9`Tz{ Sz' S� �. <br /> Pmlect Adtlre�51�� know'�i --— <br /> Attach four(4)ce,:ies ol plans for proposed work- Draw to s���.le and note the lollowir,g as applicable: � <br />� • properry Lines • Cenlerline of street /� <br /> Y Outlinc and dimencions of all exis!ing and • Indicate North �1� <br /> proposed structures on ihe lot � Show any proposed r,rading changes <br />� • Exisling and propnsed utililies o Rhuw measurements � <br /> � <br /> �-` � � 00 NOT WRI�E 3ELUW �FIIS LINE /0, <br /> r � <br /> ( ��I� PERMITCONDITIONS ��� <br /> � 1.All calls for inspection shall be made 24 hrs.in advama-phune 25a•8810. � <br /> 1 ` <br /> 2.All work shall be pedormed in acco�Jance with this pr�r�it ard current City of Everett Design and Construcdon <br /> �,v_ Standards and Sper,ifications. <br /> ' 3.CaU Location Undergwuud Service 48 hrs.betore you dig.TOLL FRFE NUMBER 1•800•424•5555. �t+, <br /> I � r <br /> .� ias <br /> /, �.A/L � ��!-�/ �li1'� di�si.toR� GL UQ�'_ VY�-�'� � <br /> d <br /> ' ` r # 3B—� �2�s'�z'z.c� S�a:n..-,..�G-c S�I/�<�o�v '�"ca'-f � � <br /> ,� o <br /> � �c.7`u.�r6� � .�t`./li� <er.�c� . ♦�j <br /> i Wd <br /> I !1 � � <br /> i. � 1�I <br />� .4CKNOWLEDGEMENT OF CONDITIONS <br /> , Q(, '"he undersigned owner/applicanl hereby a<�rees to hold and save ho�nr <br /> ��• �� --. iass ihe Ciry M Everett Irom any and all claims for dama9es, �:osts. <br />� e<penses, or causes ol action ihat may arise because ol insi:diotion <br /> . � / �J /�_� 8��/9� and maintenance of the improvement or other right�ol�w�v ����' ����reto <br /> �/����'�j� aoplied br and lurther agrees to remove same upon not�o; Irom ihe <br /> �7ate <br /> AFPruve9 for Construc'�on// / City and 1�replace public property damaged thereby. <br /> / / <br /> �.1Gt-�' !"�- A��—j� <br /> FINAL WSPECTION �a'e Da1e <br /> Approved as Constructed Signature of Applicant <br /> b'lOHK AUTHURIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> everel[ PUBLICWORKSDEPARTMENT �g0 �AYS OF DATE PERM!T IS ISSUED AND TH�I7EAFTER IS TO <br /> � 3200CedarSireel C3E DILIGENTLY PUFiSUED TO COMPLETIOIJ. THIS FERMII h1Av B[ <br /> EvereU,WA 98207 CANCFLLED BY THE CITY UPON ANY`TOPPl,GE OF VJORK ON THIS <br /> Phonc 259�8810 I PROJECT OVER 90 �AYS DUR�TION. <br />� --- � "' � '� <br /> � . <br />