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k <br /> � <br /> Date�?��9a. �" �,,�,��,�,,�,�.�P,.,:�„� , � L—SZ - <br /> / ' r n(� T A (� � Bni� Deni : � � 7 G <br /> yn~ A�fplica�ionFor lo I�liClli�l7_ �� II�I� Q'I —,J Z'�"`�—.. <br /> ['xq C:1� ' � — __ <br /> PUBLIC W�RKS PEi�it� l'T Pab1ipW.°�=��° <br /> .o x x Ta�e�F�� s <br /> H � <br /> 9 H V1 O tess aoo� Frr�':��d 5 <br /> �' o :, � r n � <br /> H �.3 x- c� r� o tn :� o ba�a�<e Uuc S�� <br /> y H Pflnt Of �yp@ Only � r�i iri o .: c� i� <br /> 1� O tA Cd 6l O� u� CJ r^ <br /> y.Ki ill !« M u�. .� . <br /> �-1 UT C <br /> � ai� l� P' n P r r N �CI`� -9�1 �°'.�'�/7K .f� ��r��P ��/() 7 J���7���3 <br /> y xr pWn^_r �M11aik�rl r 5� _- nc G�y Zip Phone <br /> �/�! r., c`�� � w s �� <br /> p CJ O G1 iiw U U5 � W <br /> L•l O � �,� _I J W CC = <br /> � � �., :� � mn � <br /> cH SqW� <br /> �/� �g ApphcaN Mailmy Atldress C�ly Zip Phone <br /> y�V C] <br />' H C. A '' � � ' �",, I /1 n / <br /> z F13 Dear.rihe Proposed Work _(��_[�,1e11—.t_tcu.: �L�1LL-F�/�=�n- �U� l �-+- <br /> ryz l r, c„ fr",;,, �; <br /> h+H _ — <br /> gy <br /> H <br /> 6 C7 p� — <br /> � �� — � <br /> y 0� Projecl Address Iif known� _ '� v Z' '� .-- . � <br /> ZC?— 2�--- <br /> Atlach lour 14)copies ol plans for proposeA wo�k� Di:uv to sr.alu tmtl note!he lollowin9�s appLr,�blc � <br /> • PropP.rty Lines • Cen�erline of sire�•! � <br /> Y Outline and dimensions o�all exsnnr7 and • Indicate Nurlh � <br /> propOSe(1 S(rUCIUreS o�.II1C IOI • $hnVl Orly Pfo{�OSrU t)1:1t1iPi) CIL']ncJP.s <br /> • [eishnq ,ind IlroPased ut � i Shu.c inuosurenicnls � <br /> D(1 NOT NRITE BELOW THIS LINE � <br /> � � <br /> o� PERMIT CONDIilONS <br />� 1.All calls for inspection shall be madn 2a hrs.in�dvance-phone 259•881 Q � <br /> 2.All worl:shall be perinrmed m acco�dance wiih!his permi�antl Current Ciiy ol E:erett Desi9n and Conshuction <br /> Ee., � Standards and Specifications. <br /> �^ �� 's.Call Location Underground Service 48 hrs.belore you tli�.TOLL FREE NUMBER 1-800•424•5555. � <br /> 4_ ]natall rock con�Y.ruction ent:rance behind dri.veway a�a <br />; i� ��' per city atandard #208 to eliminato tx•acking mud onto � <br /> otreeY.H afl direci:ed by Public Workn Inepector. <br /> �"'� 5. Reep city aLreota clean at all. timea_ <br /> 6. Curb, gutY,er and sidewa]k in the plat are new and � <br /> � ,� undvnag�d, any dz+mage thereto shall be replaced at 1:he <br />, e,�,� diacretion of. the Publ.ic Worke Inapeutor_ ♦/\ <br /> 7_ Any chan�e .i.n ihe driveway cut muet be approved bq� t:he �/♦ <br />, Public WorkA Innpector_ O <br /> � 8. 7'i.ghY.line all. roof, yard and driveway drai.ns f.rom <br /> " "� housea Y,o G.�_ stubs at back of si.de walk wiY.h rubber A <br /> gaaket: P_V.C. i�i� V� <br /> '.o. 9_ Adjuat wal:er bo�xen to �;rade at end oF construction. <br /> f� ]6_ Drivewnya �hall he c�mplotely cui•�d before driving on <br /> � �'h��' �CKNOWLEDGEMENT OF CONDI110NS <br /> C��S�/, ;��� Thn unJersqned owner;applicanl hcreby ac�rees to hold and save harm- <br /> ' �i - --- less �lie Ci�y ol [vere�l from any and all claims for Aamages, cos�s. <br /> � expenses, or causes ol achon that may anse because ol installation <br /> ��.�1 ��_ �_��� � and mainie.i�nce �he improvemenl or o�her rigM-of-way use hereto <br /> PV t <br /> ApP���ed o� Conslructloi Dule �P���°��� �o!ontl r(hei agre�:s to removi� same upon nobce Irorn ihe <br /> � Cily m}d In r acr. pubh fope fdamaged �hereby. <br /> � � <br /> �'_.�_.�/,��.�.�'/� �� �� /��, �- ����� . , <br /> rINAL WSPECTION � 7� Datc � <br /> Approved as Consiructed iqnature of Applicant Date ', <br /> ev��rett PU6L�CWORKSDEPARTIdENT WORK AUTHGRIZ[D BY TFIIS PERMIT MUST BE STARTED WITHIPI �' <br /> � 9200CederS�reet �BO DAYS OF DATE PERMI7 IS ISSUED P.ND THEREAFTER IS TO <br /> Evere�t,WA 98201 BE DILIGEMLY PURSULD TO COMPLETION. THIS PERMIT MAY BE I <br /> CANCELLED BY THE CITY UPOIJ ANY STOPPAGE OF WORK ON Th11S � <br /> Phone:259�8810 PFOJECT OVf_R 90 DAYS DURATION. � <br /> �'� <br />