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YO POSTING '�"_ '-= ��' <br /> C'J � <br /> Applitalion For <br /> Date '� <br /> PUBLIC WORKS PERMIT public Works p, rmit N o8 <br /> PUBLIC WORKS DEPARTMENT ut <br /> 3200 Cedar Street � /� l <br /> Everett,WA 98201 (425)257-8810 Building PermidM lo�0 3 S <br /> r , u, <� � > .;� .� -. , <br /> TYPE OR PRINT ONLY n ,' ` : `' � �� ' PU�Iic.,WorkS Fee S �� <br /> . ai tT u^) � � . . : f'J M J U .vi- '1 <br /> �;dcIGW� N�ai'�'��5 �gox G(�i �I�vHhv�lle � q8270' 36o d53 3a4fs <br /> Meiling Atldress �' .:.:���Y� ,:, �.,.i .�P c�c :� ;,�- Phone <br /> .j � s� x _t - [il !�1 _r �— <br /> .i. _ _� t� c, ,_ f� ,_ <br /> APPlicant Mailing Addresa " .� "C�ry " .. _ ':7�p'. �, . , phone — <br /> Describe Proposed Wotk T1vv7Qi W <br />� � <br /> � <br /> � <br /> PROJECTADDRESS (if known) G7'J�4 �'U' /�� �++ <br /> Attech four(4)copies plans for propased work-Draw lo scale ard note the fdlowing if applicabie: O <br /> •Proparty Llnes •Outline end dimensions of ell existlng and proposed structures on the lot •Existing and proposed utilitles � <br /> •Centerlino of street •Indicate North •Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: O <br /> 1. All calis for inspection shall be made 24 hours in advance- phone (425) 257-8810 <br /> 2. All work shall be pertormed in accordance with this permit and current Ciry of Everett Design and � <br /> Construction Standards and Specifications. , <br /> 3. Call Location Underground Service�� hrs. betore you dig. TOLL FREE NUMBER 7-800-424-5555. /A <br /> \/♦ <br /> � C�on,� ���i� �rmo�F f� ,��� o��h SfvS �►�vGded a <br /> o►? Lb� <br /> ACKNOWLED6EMENT OF CANDITIONS <br /> Q� � � � The urWersigned owner/appllcaM hereby apreea M hold erd save hermless <br /> the Ciy of Everett trom any and ell cleNns Mr demeges,cos5,ezpenses,or <br /> pr e or^ ns ryc io — a ceuses of actlon that msy adse because of instellatlon and mNnNiwics of the <br /> �j imprwemem or other rightcl-way uae herelo tor and fiMher egrees to <br /> ` /� _23_f remove seme won notice from nie and ro rep pubitc propeny dam. <br /> . H c�,. �� l� mareby. <br /> FINAL INSPECTION Date <br />� Approved as Construded <br /> I�� gna re e <br />� W'OFiKAUTiiOR�BY 7HIS PERAAfI'MUST BE STARIED WfTHIN 18D DAYS OF OMiE PERMT IS ASSUEDMD IS Tq BE DL.I(9B1tLY PURSU�10 <br /> CONPLEIION.hRS PERMff M�1Y BE CANCELLm BYiHE CfTY UPON ANY STOPFMAE OF WOFiC ON 71115 PRO�ECTOVEFi 9D Q�►YS Dl�iA710N. <br />