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� i <br /> , <br />, <br /> ; <br /> a <br />� <br /> ; <br /> , <br /> � [�1818��11�� 1 l.�l �imi�c vlmks cmm �1L� � '� <br /> � Binn Depi.. ._i.._��� '�""_ -. <br /> Applicalion For '� <br /> PUBLIC WORK:i PERMIT ''°',��°W°°=F�.� - ' <br /> ro���F�� s_ � <br /> te;snnul FeePaip 5 <br /> ��� <br />� �alanr.o0oe $ 1���— <br /> Print or Type Only — <br /> r--- �, �� � e� � , I <br /> -If►r��i�� II1����'x�l =-� I l��C`� l�11,U -.l I1uY"l �71� �<GIC� �� r7'� i <br /> Owner �daillny Adtlress Cny 2ip Phone i <br /> tn , C I <br /> �J��I � ) <br /> Applicant Mai:ing Address City Zip phone I <br /> Descnbe Proposed Work -� � ��>2- � �/ i .� ���f�� �rA �'�t.� h �� _ � <br /> , <br /> Pro;=cl Address(il known� � 7�� ,Jt� �1��. � � <br /> � <br /> Attach four(41 copies of plans for propos�.�d work- Drak� lo sr.ale and note the following as applicable: � <br /> • Property Lines • Cnnterline ol street � <br /> • Outline and dimensions of all ezisting and • Indicate Norih <br />� proposed strucWres on ihe lot • Show any proposed 9radiny changes <br /> . • Existing and proposed utililies • Show r,ieasurements � <br /> os <br /> � DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS O , <br /> 1.All calls lor insper.tion shall be mada 24 hrs.in advance-phone 259•8810. � '� <br /> 2.All work shall be pedormed in accordance with this permit and ..urrent City of Everett Desic�n and Consiruction <br />. � Standards and Specificaiions. �I <br />. 3.Call Location Underground Service 48 hrs.Lefore you diy.TOLL FREE NUMBER 1-800•424-5555. � <br /> � <br /> %�. /�yY/.'�-t�� .� �.�/lc��c:.��. /'i..:,/ ��.,:�� �ji.T��r' . ;�G'�ioc���. t�C� � � <br /> i ����' <br />, rZGC��� C,���.c!Ccc%�Y.� CZ-1-r�-a�c.�i_,' � . `� ' � <br /> � �.'r l: � ('!:' !. � t L '_C ..Ic'2�4:. ..l' <br /> ; .�h6Cc,2/�t� .(?fi/"�.%!n!� :t:: ~ <br /> � L .�����...:T�l � 't i. - - 'i . , . � . . r . . � <br /> c< _t - � ., -'-4�� . �,.� ./ .. . . <br />�� . . . .. , (' _ � �. . ,/� . _ <br /> . �j , T� :,... . �.i _ . � O <br /> � ' <br /> �CfWOWLEDG�MENT OF CONDITIONS <br /> The undersigncd owneUapphcant hereby agrees to hold and save harm� <br /> -� --- -- iezs tl�e City ol EvereU Irom any and all claims lor damages, costs. <br /> expenses. or causes ol ac�ion that may arise because of installation <br /> �,/�. ' i, �_ �; and naintenance of the ���npruvement or other righ'�ol-way use hereto <br /> �� � "���` ��������� �" ' ��`���— applied lor and I�rihar agrees to remove same u;r�n no6ce from thc <br /> Approved lor Co�ir�ction . Date Gry and to replace public property damaged ihereby. <br /> G�lJ . <br /> �/� �f�/- `J% �—�, <br /> FINAL INSPECTION Date ' . � ��� � <br /> Appwved as Constructed ic��a�& e of'Apphcan� Date <br /> evere[[ PUBLICPJORKSD�PA7TMENT WORK AUTHORIZED BY THIS PEFMIT MUST FiE STARTED WITHIN <br /> � 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEkEAFTER IS TO <br /> Everett,WA9fi201 BE DILIGENTLY PURSUED TO COMPLE710N. THIS PERMIT MAY BE <br /> Phone:259�[i810 GANCELLED BY THE GTY UPON ANY STOPPAGE OF WORK ON THIS <br /> PFOJECT Ob'ER 90 DAYS DURATION. <br />