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/^/�> . <br />••► :� <br />Tn POSTING � 2 b 20°�` <br />Applicauon For <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 (425) 257-8810 <br />Date � !"i 9 � <br />Public Works Permit M �9 �'¢� <br />Building Pertn(t 8 �� 3�_ <br />TYPE OR PF.INT ONLY Public Works Fee $�O� <br />c�us� I�si� Cans�faac,�io►, �P,ry,c Z�F3 �ve,�� �Zo3 308-3 i�`1 <br />Owner Mailing Address � Ciry Zip , , Phone <br />Appliwnt <br />Describe Proposed Work �d�_ <br />PROJECT ADDRESS (if known) <br />GL�1G <br />3Z15 �S-� <br />Attach lour (4) copies plans for proposed work - Draw to scale and note the following if applicabie: <br />• Property Lines • Outline and dimensions ol all existing and proposed structures on the lot • Ezisting and proposed utilities <br />• CenteAine of street • Indicate NoAh • Show any proposed greding changes • Show measurements <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall te made 24 hours in advance - phone (425) 257-8810 <br />2. All work shall be pertormed in accordance with this permit and current City of Everett Design and <br />Consiruction Standards and Speci(ications.. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />� � �d h.en2 -�o sm� � I /n �E �M P `�f d�ih�) <br />� G'v� �ev� dowH ,t,pov-� s-� S d� �ek/s-✓. <br />V <br />�i � S,-�c S�e,� � � i � <S�a� '6`(00/ <br />�� �4�� ����5 � �y -.�-- ��h; � . <br />p rove or / is ruc n a�r�/� <br />� ;��, .z - �a_ �� <br />FINAL IA�PECTION Date <br />Approved as Constmcted <br />W <br />F— <br />r <br />� <br />� <br />O <br />� <br />Y/ <br />� <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersi�ned ownerlapplicent hereby agrees to hoW and save harmless <br />the City of Everett from any end all claims ta damages, costs, expenses, or <br />causes ot actlon that may ariae beceuse of installatlan and maintenance of the <br />improvement other nghboi•wey use hareb applied for and further agrees to <br />remove sam uporynotice Irom the Gty and to replace publk property dem- <br />age � <br />� vs- r �. � . <br />i ureo pi n ae <br />WOFiK AUTFiOR�D BY THIS PFAMfT MUST BE STARfm WfTHIN 180 DAY`' OF DATE PEFiMfi IS SSUED PNO T}EREAFfEH IS TO BE Dl1GEMLY RIRSUEDiO <br />COMPLETI(NJ. 7HIS PeRMR MAY BE CANCELLED 8Y'I}iE CRY UPON ANY STOPPAGE OF'M%ilC ON 7HIS PHD,EECT OVER 90 DAYS IX1RIITION. <br />