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� y . <br /> ��� ... <br /> � H fn <br /> H� � <br /> FC O <br /> ��'� —,`�� x� . � � -- PuULc\VoiF:Permd a `�. <br /> �y� Date , .�..h'�J � omn.n�w.. � 1.�.-��-- <br /> x Hpplication For <br /> o� d PUBLIC �J1/ORKS PERMIT PUOToIaiFoeFeo S <br /> ��g �ess non��'eo aa�a S — <br /> �y ('] �alan<a0ue S <br />' 9 y� Print or Type Only <br /> t•� <br /> �+y �"� �%n �1�1i�� "�� =� �-.�c , ,r�� '1'� :-� f_ F ���R��:� � �� �',�(;`C ���` <br /> 5� �� l�l�i . r�1 �� Y.—� Y�? � Zi Phone <br /> �Q y Owner Mailing Addrees ���Y p <br /> L�1 � <br />� . : �� � � �� �1�1�� ��`','�1--��^�� <br /> �tA � I ,� >c �e t r �� r-J'� �I �� � !-1 )r4 i�C <br /> y �t�""�-!�� Mailin Address Cdy Zip Phone <br />'� . _ __- pPP�:?nt 9 <br /> T � 111A �^ r )� � <br /> I � Dascribe Proposed Work ,rt � � �����-��� �l l�'v� -- <br /> I <br /> I -- <br />�, � - W <br /> ProjectAddress(if known) �� �- � � .�-�--�-�5 1N ._. _ 7{l _ L <br /> �� <br /> Attach tour(4)copies ot plans tor proposed work-Draw to scale and note the followiny as epplicable: � <br /> • Property Lines . • Centedine of streel <br /> • Outline and dimensions ol all existing ar�d • Indicate North <br /> proposed structures on ihe lot • Show any proposeJ grading changes . <br /> a Exisling and proposed u�ililies • Show measuremen�s M <br /> i1 DO NOT WRITE BELOW THIS LINE O � <br /> �' PFRMIT CONDITIONS <br /> '�1 7. All calls for inspeclion shall be n:,rle 24 his.in advance- phone 259•SB�5. � <br /> 2, All work shall 6e performed in ��:���orCsi�ce with this permit and:vrrent City ot Everet�Design and Consiruction <br /> Standards and So=citicatiois. � <br /> '�' 3. Call Localion Und=ryrouno 3�- ,ice 48 hrs. bebre you dig.TCLL FREE NUMBFR 1•800•424•5555. <br /> ' �/5 .aEK r,::T /.S , ✓�'" �i�v�i'Eo O <br /> c�;✓ � <br /> f� 7/��97 � <br /> � � <br /> O <br /> '- a <br /> ►-i- <br /> �-� <br /> '_' ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owneqapplicant hereby agrees to hold and save haim� <br /> � � less the Ciry ol Evere�l trom any and all claims for damages, cosls, <br /> nxpenses. or causes of ac�ion thal may arise hecause of insta!lation <br /> :�nd ma�ntenance ol the improvement or other ri9h4o1-way use nereto <br /> applied for and further a9rees lo remove same upon nolice trom ihe <br /> Approved for Construc;ion ���e City and to replace public property damaged ihereby. <br /> FINAL INSPECTIt`4 Date Date <br /> ^porovca as Consi��:±�;��d Signature of Applicant <br /> WORK AUTHORIZED BY THIS PERtiSIT MUST BE STARTED WITHIN <br /> everett FU3's ��VJGRK::I`FvpqTMENT 1g0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 92;iG Ccdar Strezt BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMI7 MAY BE <br /> Er:; 2i?,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> ph.'.� ��:259-8815 pROJECT OVER 90 DAYS DURATION. <br />