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�wil <br /> �A Wl" • <br /> � � <br /> I <br /> /� <br /> Date �I–�5 ,�� � ,�..�..�,. , 8`�'3@�7 . _ <br /> AnPlic��icn for � u.c' � . Jr �l f 7 L/-1.7_ <br /> PUELIC WORKS t�ERR1iIT yz,q� '; °��°"°"="` - s <br /> ��1�f IDtal Frr � - <br /> �'9`��H � <br /> ID.K7 H �e:s sna� Fe�va�,n S— ___. <br />� >Hxv� PrintorTypeOnly TO P(15T�NG _ �� z����� Bo1n°�o�• s �_�� _ _ <br /> HZH <br /> oxo ��aE—� f�P �� � ZGGti'ocke�a IP. L'�ailfH9� _o� 7-SZ - �Zn�_ <br /> 's� H�+l Ow er Madiny Atldress C�Iy 'Lrc: ?horie <br />', t/:HH <br /> I � �-3� APPlicant P.ladmqAAdress --_ Gly --- Z,{i--- Phc-nC <br /> OH <br /> ��� Descrihc Pioposed Wo�A _. •��:,��-�J����MJ�y�-p�J�•1'1� — — ----� <br /> 'Y. H� — _ <br /> 9 y z -- --�--- <br /> t" <br /> �+H — <br /> y � <br /> N <br /> � . ,� . _ — . _ __ <br /> O <br /> �" c , , I , 7!� �� � <br /> � 3 y L� Proiect Address(il knownl — __LL.LG_�Z.�-_�L��-C---- '------ .. <br /> C�f C+J <br /> Att3Ch four�4)Cop�es ul �;1a��5:cr pro(.JSetl v+ork � Draw ir .d�• ;mA nct��� ti',�� lollovim� as applica:;li� � <br /> H O c� 'A <br /> R/ Property Lines • Ci�n{crline o�S�roel �� <br /> • Outlme antl dimensions o� au e..c;i��•�� anC • Inai<.+�e IJonh <br /> � proposed sirwtures o�� ��x lo� • n^.��'. any proposed yratlm<3 �nanges <br /> • ExiS:�nQ and p�0005etl UI�LhrS • S���v: me05U�eni�n'S M <br /> W <br /> �oNor N��eee�cc� Trnsur�t O <br /> '� PEFMIT CONDITI�)NE <br /> `�� t,All calls io�inspectlon shall be matle 24 hrs.m advance-phone 259•$$1 O. � <br /> 2.All work shall be Fertormed in accordance vnth'his ce�mit and cunent Ci'y cf c'ierntt Des�9n and Const�uclion <br /> StandarAs and Sne^.dications <br /> 3.Call Loca�ion Untleryround ServiCe Jft hrs �^�cr��you a�y.TOLL FREE NUMBER 1•800•424•555$. �� <br /> �� <br /> O { <br /> 1��j � <br /> �� I <br /> � � <br /> i- 0 ' <br /> __ <br /> a ; <br /> r.� � <br /> �� ACKNOWL[DGEMENT OF CONDITIONS <br /> ��r ;h�r undeisigned owner/apP�irant hereby a9rees to hold and save harm- <br /> less Ihe Gly ol [verelt hcm any and all r.laims tor .ama9es, costs. <br /> �4 ��i cxpenses. or causes ot acbun ihal may arrse because � ' � ;�allat�on , <br /> � � �'� / p anA ma'mlenance ot thn nnprovemenl or olher righPot�wao ��5� horeto <br /> /( , C( ��l�� � �/� �C ���� _ � � �l "(� �nn'�c�d ior and :u�u,er a9rees to remove same upon n tica ' om Ihe ' <br /> qpprove �or Consiruction ���« Gly on�� to replace Public properl7'��'��9;d �hereby. <br /> `/ / y_ -/ j�/. � � <br /> c_s!,,l/c ' =�� �� � i <br /> �' - -- i; :,s-�— � !//,���_.�� <br /> FINAL INSPECTION Uale �-.�=�--�— m�� L — <br /> Approved�s Consiruc�ed oignat e ot Applicant Da�e <br /> W�K tWTHORIZED BY iHIS PER1� i MUST DE STARTED WITHIN <br /> p��� PUBLICWORKSOGPARTMENT 180 DAYS OF DATE PERMIT IS IS U[D AND THcRLAFTER IS TO � <br /> � 3200CetlarSireet 6E DILIGENTLY PURSUED TO COMPLETION. THIS PERAIIT MAY B[ <br /> Everett.WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:?'•9�P910 PROJECT OVER 90 UAYS DURATION. <br /> �,__. �. <br /> I <br />