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i <br /> � i�� <br /> � � <br /> I �,� <br /> �•,:� <br /> i ,-� <br /> -,� <br /> i ;;`� <br /> � "':1 <br /> � � <br /> ,`.�Date_7�1�s1� �„„��•No,k�P�,m��< _ 1�73 '29� G <br /> Application For Frn�.oeoi.• —��_�Q��j <br /> i �Y��� �V ��� i�� ���� �� Pul�i�cWo.ksFov � .;�r�-� <br /> TMaIFcc $ "'�� <br /> WSCFppI F¢ePaW � <br /> [lalancc Duo �u ���� � .������-� <br /> Pr iI Gf Typ,, On!y , <br /> ( <br /> I _'�-'� <br /> J2f r���7a a a�D'''� s,-S��= _�v pv�L/`� I,}�cr�— ! i;: <br /> Owner Mailing Address City i� Phone � <br /> � ; � <br /> �� <br /> Applicant Mailing Address Ciry Zip Phone <br /> Describe Proposed Work NQ(�,J .Tlti�.�P 'hv�, ��������,fi ��1 S f�n �Lf � L t.T y� <br /> Project Address 1if known� ��%J�/lJ — /����—� � � <br /> � <br /> Attach fow(4) copies ol plans tor proposed :vork- Draw to scale and note ihe(ollowing as applicable: � <br /> • Property Lines • Centerline of street � <br /> • Outline and dimensions ot all eaisting and s Indicate North <br /> proposed strucWres on the lot O Shov� ar,y proposed yradin9 change;s <br /> • Fxisting and proposed utilities • Shov✓ meas�remen!s � <br /> DO NOT WqITE BELOW T� <br /> PERMITCONDITIONS � � <br /> 1.All calls for inspection shall be made 24 his.in advance-phonE 259$810. � <br /> 2.All work shall be performed in accordance with this permit and cu«eN City of Everett Design and Construction <br /> Slandards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800•�24-5555. � <br /> �� . iil�l`� � i1AiVf�F T,N TH� D'r�.[VFId(lY ( �.1T I�IUSf 1;1-: ( I I ' �1�IF=1� <br /> H ' IHE F'UPLIC WORF.L; 1NBF'CC' fOR. � i <br /> ,� ,iJ�� F'UBLIC DFiAINI1L-'� �;YiTCr9 f1S f'ROVIDED �OF. Ur�i,iil ' �li_I1 ' � . ; <br /> �. (11`dl' LOT GFFIDE CFIFIh!GES MUST E�F. AF'F'FOVFD EiY "II�f[ � <br /> ;'Ufil_I�; WOFi'r::5 SN�i=rCl'Oli. <br /> ? , f::l=Ef' C1.'f`( �'�FiE(_TS CLE{1N F1T ALL. 1"1hiGi. �A <br /> [NST(�LL. WATER [�QXF_S TO Gf�(1DF F1T THF EI�I['i Of= '01!'; fF;i it'T LiiIV �r� <br /> ' , P1(-1k::I= f'.l.�fiE DFi1:VFld{lYf; ARE �:C)P"IF'L.F'TELY CURF..L> E{EF'OR[=. � <br /> t�<ii:Vzhli� �t� 'fl-�i_'19 . <br /> Jl1, i �" lii��llf I I . �il � � I . !'lli I( "!:`I Il �_�I�I� I � II ','I_ 1 � �.. 1�:� .. � I:'I�:Y1 � ''� <br /> I . lii.�. l� � �.r�i f .l, � I(�III .li lill � II . Y ( ..I � 'I.f I_ I� '. <br /> �CKIJOWL[DGEf.1FNTJFCONDITIONS I <br /> �� _ The undersgnaU owner/applicant hereoy agrees to hold and s�ve haim- � . <br /> — Icss Ihe Cdy oi Everelt irom any ard ail claims for damages, costs, � <br /> expenses, a causes of action th�t �nay arise because ol installalion '� <br /> _ � 7 7jy,aa and maintenance of ihe improvement or o�her ric�ht-ohway use herelo i <br /> applied tor and luriher agrees to remove same upon notice from the <br /> App�r ved lor Construction J Dale Gity and to replace pubGc property d 3ma9ed thereby. <br /> i 1-c Hn.l rcf �uc� ,r� .w.eeieQat�� `i/��"1''"cc�� c�irr ���-���P� G(ri p <br /> FINA�INS[CTION�� ��� t� ������ Date fJi���( <br /> .�, /uh ��z/O ` <br /> Approved as ConsVucted Signat re of Applicant Date <br /> evere[t PUBLIC WORKS�EPAFlTMENT WORK AUTHORIZED BY THIS PERMIT MUST 8[ STAHith LVIiHIN ' <br /> � 320oCedarStreet 160 DAYS OF DATF PERMIT IS ISSUED AND THEREAFTEh' IS TO <br /> Everett,WA98201 BE DILIGENTLY PI'RSUED TO COMPLETION. THIS PERMIT MAY EE <br /> Phone�259�8810 CANCFLLED BY il ic CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVEN 30 DAYS DURl,IIO:J. <br />