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� . ' ,� <br />^l.b: <br /> � � � <br /> r. <br />. � � <br /> �..,,,, ><at_� <br /> , 1 � <br /> r , <br /> ' i <br /> I <br /> I <br /> � <br /> ; <br /> '. ' �,1 .,.•:�� .,; , :, . <br /> � <br />� ' ,.�. ��o-�E::.; � +�"�+ �. , .�; � -� ux <br /> . . - ' . .. • . ris+'�b <br /> ��A�] Date � ., r�oeo woix.�a,m�n. __ �� , <br /> {p Applicalion For emg oeo�.•3�-���n � � `L____ <br /> I-I <br /> �� PUBLIC WORK� PERMIT °°°:oa����°�� : <br /> Lese Apo�-Foe Pa�U S <br /> :, ��� Balanca Due S _ — <br /> Print or Type Only <br /> ��� i9�µ AvE �-r�k . INc. , I`1I2.� tibu�►tr�2�� fl�.w4 :F3o-n-t���98oII 4�3-�{0� <br /> , p� Owner MailirgAddress CdY Zip Phone <br /> ��S• h1A5HIt��TON ��. ��:�� �ci4 N� i�a� s�x+-m� `$ i���5- ..�7 <br /> ly Applicant Mai�ing Atldress City Zip Phone � <br /> !� <br /> � p� Describe Proposed Work �T i <br /> I ', �� — <br /> �� W <br /> .. ._Y_ . �O C�- C (� � <br />. PwjectAddresslilknown) �n���L-IT� �V� -� AVT� _ �� <br /> Attach four(4)copies of plans lor propo;ed work-Draw to scale and note the following as applicable: � <br />��, . • Property Lines • Centedine at street /A <br /> . • Qutline and dimensions oi all existin9 and • Indicate North V� <br /> proposed sirucWres on ihe lot • Show any proposed grading chanyes <br /> � • Existing and proposed utilities • Show measurements � <br /> i <br /> � � DO NOT WRITE BELOW THIS LINE <br /> II - � <br /> 1 PERMIT CONDITIONS I <br />�� ���� . 1.All calis for inspection shall be made 24 hrs.in advance-phone 259•881 O. �y � <br /> I i 2.All work shall 6e pedcrmed in accordance with ihis pe�mit and current City of Everett Design anrJ Construction ♦ <br /> Standards and Specifications. <br /> � 3.�all Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 7-500•4?.4•5555. � <br /> � ' <br /> � � <br />, � O <br /> n/ I <br /> � � /!/b '�� �C�L <br /> � �� 7' c-c� <br />� , �i�1�-ci �o�- �' � � � <br /> �� Oy� <br /> qh '�3�c'-�r� <br /> �%Z- Z.� '%0 � <br /> 1�� � ' <br /> ��� � <br /> � ,- <br /> a <br /> __ <br /> ACKNOWLEDGEMENT GF CONDITIONS <br /> __ The undersi9ned cwner/applicant hereUy agrees�o hold and save harm- <br /> less the CIIy of [verett irom any antl all claims lor damages, costs, <br /> ��� eznenses or causes of aclion ihat may arise because of installation , <br /> and maintenance of the improvement or other ri�ht-of-way use hereto ' <br /> � " applied for and lurther ayrees to remove same upon notice irom ihe � <br /> Approved lor ConsVuctiun Date City and to replace public property damayed thereby. <br /> FINAL INSPECTION Date � <br /> ApProved as Construc�ed Sic�na'.ure o�ApPliCani Date I <br /> WORK �UTHGRIZED BY THIS PERn41T MUST BE STAFTED WITHIN � <br /> everett PUBLIC WORKS DEPARTMENT 180 DAYS OF DAT[ PERMIT IS ISSUED AND TNEREAFTER IS TO j <br /> � 3200CedarSireel BE DILIGENTLY PUPSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everr.IL WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK UN THIS <br /> Fhone:259�0810 pROJECT OVER 90 DAYS DURATION. <br /> � <br /> I � <br /> ,� <br />