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�-- .. _ . .. . ._ j! <br /> I <br /> i � <br /> ; <br />��� � �`� <br /> — i <br /> � <br /> � � <br /> Date��3��` a����wo�ks P�,m��.p-- c�f� — Z i J <br /> Eilh� DePI.+ �o u� �.'J,� <br /> Application For I <br /> PUBLI� WORI�� PERMIT PWIicWorksfee — _— I <br /> m�ai Fco g — ' <br /> Le55 AppL FC¢Ppitl 5�— � � <br /> o,i:����o�e s�"�Do + <br /> Print or Type Only -- --_ � <br /> i� � �� ' .I <br /> I�C (�nw o�s.c�.�_r�. a �aa /�� �J�� �7�zn,� 3��-03.�, <br /> Owner Mailing Address Ciry . Zip Phone ��� � <br /> S�N`,t' I�� <br /> Applicant Mailing Address Clty ��p Phone , <br /> Describe Proposed Work /� '��(J ,S�{�`J�P-�i��� ���A,���.L) (�'� e2� [�j.�1f���� lil <br /> !OB// - /a � L� SE � <br /> Project Address(il known) __ <br /> � <br /> At�ach lour(4) copies of plans tor proposed work- Dra�v to sr.zle and note Ihe following as applicable: � �' <br /> • Property Lines • Gente�hne of street /q, � <br /> • OWline and dimensions of ali existing and • Indicate Nor�h dt t � <br /> proposed siructures on the lot • Shov+any proposed giad�ng chan9es I <br /> • Existing anA proposed utilities • Show measurements I <br /> DO NOT WRITE BELOVJ TNIS LIN: �yj� � I <br /> PERMIT:ONDITIONS � <br /> 1.All calls for inspection shall be made 24 hrs.in advance-ohone 2S9•8810. � <br /> 2.All work shall be pedormed in acwrdance with this permit �od c�rrent CiPy of Everett De�;i9n ancl ConsUuction <br /> Standards and Specifirahons. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FR�E NUMBER 1•800-424-5�55. � <br /> ,, _ . , :, -, � � ��. � ;�;, �� �. � � I <br /> � .,�� i . .. _ ., , . . , <br /> 1 I L'.. i � C 'L � 1 �C � � ! <br /> - � i,� �'UL�L ii DF��I�dArF �rSi �t�1 A� c�i7Vl1)1=�i ( uf, ' .' <br /> ar•a�r �o � r j��r,�e c,;r�racr. � r•iu�.T z�� a�r-�,r;o�:r_n r , L <br /> �� � Tc wnrr s �rt� �ccrai,, � �_���•a� r�,_ ;. �♦ <br /> � F:.i` i.t i ' i i Cr f� CI t flid !'iT F1LL i tl1"_ � i <br /> � :�i`'Tt=�l.' I�(}TE1i IIO'C� TO 6RF�G[- ri7 Tli�. <br /> _ .. <br /> �'(t f`<�l. 't PRP tJi Y� f �C C�1'li'Lu_TCI_1' CJ�;LD LL� �? ... � � <br /> ,_^, � L'-'T''1 ] I]Iv: T'' E 1. ' <br /> ... ... . .. . . . . . . . .. ,,-�.. . . , � ! <br /> i�CkWObl�LFDGi_FdE'V�� OF CONDITIONS '! <br /> Th�= undersi�ned owner/apphcan� hereUy ac�rees�n hold antl Save harnr '�, <br /> — luss ihe Cily of Evere�t fron� any and all claims lor damages, cos�s ' <br /> /��� � expenses. or causes of action ihat may arise because ol installation � <br /> 3 ��j' and maintenance of the improvemenl or other right-ol�way use here�o <br /> .— applied lor and furfher agrees ic remove same upon notice from the <br /> Approved lor Gonsiru �ion Date Ci and to replac pi hlic property dam2ged �hereby. <br /> ,�c; C��L����— <br /> `� <br /> FINAL INSPECTION Date L� � , �• ,� ZI ; p <br /> Approvetl as Con;iructed Sipnat re of pplicant Date <br /> everett PUf3LIG WORKS DEPARTMENT WORK AUTHORI2[D BY ThIIS PLRMIT MUST BE STARTED WITHIN <br /> � 3200CedarStreet 780 DAYS OF DATE PERM17 IS ISSUED AND TH[REAFTC-R IS TO <br /> Everett,WA 98201 8E DILIG6NTLY PURSUE[� TO CUPdPL[TIGN. TFIIS PERtv117 L1AY BE <br /> Phone.259-�810 CANCELLED BY Th� GITY UPON ANY STOPP�GE OF N'OR��<ON THIS <br /> PROJECT OVER 90 uAYS DURATION. <br />