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� APPlication For � <br />PUBLIC WORKS PERIVI'IT <br />PUBLIC WORKS 6EPAR7'MENT � <br />3200 Cedar Street W <br />Everett, WA 98201 259-8810 = <br />T PEORPRINTbNLY�OSTING SEP � R��Q7 U <br />1 <br />owner <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />� N � � <br />�I ��` s r s� N � <br />csaoP' <br />� r�rcE-� r�s�� <br />nziu�w�.y - s �w.. <br />I11 S 4`ti` ST Sw <br />Date h.) ... CI . �� / <br />Public Works permit q <br />Building Pertnit q <br />Public W��ks Fee $ �� � <br />"�'s Z3�- �(72 0 <br />Z�P Phone <br />G��ii�i'L_ 6 S�-L,i C) O <br />Z�P Phone <br />rr <br />Attach four (4) copies of plans for propuyed Work - Draw to scale and note the following if applicable: <br />•Froperty LJnes 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities <br />'Centerline of street •6idicate North •Show any proposed grading changes 5how measu,rements <br />�-�-�..+� �rni��oCLVVV IryIJLINE <br />PERMIT CONDITIONS: <br />1. 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 perrnit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 7-800-4245555, <br />�, Trs �� L( <br />c4�c �i 6�.r�:n Per cr �� $�-a n c� ��b z <br />.�,provea as �onstructeU <br />A <br />W <br />� <br />� <br />v! <br />� <br />O <br />� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undereigned owneNapplicant hereby agrees to hold and save harmless <br />the City of Evereri from any and all claims for damages, costs, ezpenses, or <br />causes of action that may arise because of installation and maintenance of <br />theimpmvementorothe f-wayuseheretoappliedforandiurtheragrees <br />to remove same up notice f the City and to replace aublic property <br />damaged thereby. <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED qND THEREAFTER IS TO BE DILIGENTLY PURSU DaTO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />