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... , _ . . ,. . .. � � '�y <br /> •.�r.�....._ .. .. .. _. .�.. .� . .........�._�....... . . . � . � . . � �:^p�i�aw�.ul�f <br /> �flte__C�� Pumic Worka Permit♦ 8�O ��Z�� <br /> Application For eme�oea�.•��2�(�`,`� <br /> PUBUC WORKS PERMIT PuOLCWorklFae <br /> Totei Fae S <br /> . I Lbss Appl Fee PaiA S <br /> eelanceoue $ ZO O�— <br /> Print or Type Only <br /> til � ' .0:�, �� a.�a� /�1�`-c��e�l'� �s�s- ��» <br /> Owner Mailiny Address City Zip Phone <br /> �T���� <br /> —F�:ar�t MailingAddress City Zip Phone <br /> Describe Proposed Work �l �" `- <br /> Prniecf Ad�lresclif knpwnl � �< Q�� �.l�G � �n7/�— J���l�E .$�� � <br /> e � <br /> Attach fuur(4)copies of plans for proposed K�ork-Draw to scale and note the following as applicable: � <br /> • Property Lines • Centertine of street � <br /> • Outline ard dimensions of all existing and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed ulilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LII�E <br /> PERMIT COND�TIGNS O <br /> 1. All calls for inspection shTll be made 24 hrs. in advance• phone 259-Ii81 5. � <br /> 2. All work shall be performed in accordance with this permit and current Ciry of Everett Design and Constr�ction <br /> StandarcJs ard Specifications. <br /> 3. Call Locatior, Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800-424-5555. � <br /> � ��Ynv<'E' 7.eEF STUinPS - t'v �/UT PuS�'' o <br /> iNTv iP.9v..dE. <br /> ,S G,e�aE LoT S'a �'s /rloi 7'v Z,..�i9�T Sa�.eQo;�.r/o;�c�l� LOTS ` <br /> C�Jiis/ .i'Hi•✓u/?l<'�2 ,�'v.c�,OAr', f <br /> �, .c'oof% ToP �iw.� s.��vr.r 7'v dE T,-�:r.- ��ti�<o Ta if�E � <br /> Ef.'s7 - d.P - s��As�/Bcot.cs .9.�F Ta BE I�/S:HC�EO. � <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owneUapplicant hereby agrees to hold and save harm• <br /> � less the City of Everett keim any and all claims Lx damages, cosis, <br /> _-�!/ / expenses, or causes ol actien thzt may arise because of installation <br /> ��i,�;Y,6rr/�y. �-/< <4� and maintenance ot the imprc+ement or other righ4ohviay use hereto <br /> applied for and further agrees to remove same up�n notice from the <br /> Approved tor Construction Date City and to replace public preperty damaged thereby. <br /> Z�2..3t�� ��/./ /nK O <br /> FINAL INSPE N Date ���n ' ^�-� � �S ��o� <br /> Approv3d as Consiructed Signat�re Applicar.t Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> everett PUBLIC WORNS DEPARTMENT 180 DAYS OF DA7E PERMIT IS ISSUED AND THEREAFTEF IS TO <br /> � 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everett,WA P£7201 CANCELLED 6Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259•R915 pRqJECT OVER 90 DAYS DURATION. <br />