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� . _ � <br /> � �� <br /> m � x <br /> C, H <br /> H z H ' <br /> �- �.: � <br /> � � ('/� p(� /� p�j J <br /> H "�^� Date��/�%r'l�: IU I�l1�T���V__. / -? } .93 v��i�i:�_ero,x,i,.,,m��e _U__l-- c9'l� <br /> A1H �iJ _:. — . <br /> �.no o„ci.. <br /> C/J H ApPlir,ation Fqr -- -----.-.. <br /> � o � PUBLIC W'CZRFf;S F'ERIlIIIT v�����W�„=��.� - -_ <br /> H CJ ,r io�ai Frr 5___. . <br /> O H t %'-_i tessanni F��Pam 5 _. <br /> H C+7 C) �- � _ <br /> q c Daiance flue $�J� <br /> �„ C� Print orType Only _ o c, _ ___ <br /> x H�� J' n n <br /> � y €, !, \ /J �:� �, ;�, <br /> H 13 / UG G�C�=�1J �/�.��OC` . ,� � <br /> 0 <br /> �� li Owner � Maihng A�]8re k�� .. GIY ZiP Phone ' - <br /> O CJ Ip ,�' u F- i i <br /> o •�_ <br /> ��'� r�;�� s C� �i <br /> � F�pf�icen( Muilin Add�P66 Cti <br /> z y�j� 9 Y Zip phone <br /> HOn <br /> L�escriCe Proposed Work ��Lc �l/�G-� /�� ���__��j�j//C C O/e' <br /> ,��!�/�i�'(��— ' .�_i���s/c.:uN C'c� /lt_ �� . - --- <br /> OU ' .S l--J. � �%7 ^ �ri�'. �tJ � <br /> Project ACA�ess lil knownl � � �5/_ � <br /> F.itach four(4)copies of plans inr proposed woik� Dra�.v to scale and no�� "ie following a;applicable�. � <br /> • Property Lines • Centerline of sireet � <br /> O Outlme and dimen;ions of all existin9 antl • Indicate Nonh �� <br /> pmposed s�ruc�ures on the lo� O Show any proposed c�rading changes <br /> • Ezistmg anc propcsed uti�ilies O Sho�v measurements � <br /> �� <br /> '�y1 DO NOT WFITE BELOW THIS LINE o <br /> 1 � PERMITCONDITIONS � <br /> 1.All calis for inspection shall be m.-�.de 24 hrs.in advance�phone 259•8810. � <br /> � 2.All work shall be performed in accordance with this perr�iil and current Cily of Everett Desiyn and Construction <br /> ��1 Standards and Specific2tions. <br /> 3.Call Localioc Underground Service 48 hrs.befo�e you dig.TOLL FnEE NUMBER 1•800•424-5555. � <br /> 1�' <br /> '", �cl� �/��.�'7(/c��-� / ��'i'-'W' `�'����� � <br /> i'� �/l/d`- � <br /> , <br /> 1 (/� <br /> ! �_ <br /> ►�1 � <br /> ��I ACKNOWLEUGEMENi OF CCNDITIONS <br /> � The undersigned owncr/applicant hereUy a9reas�n hold and save hai�r <br /> � - less :he Gly ol Everetl Ir�m any and all claims lor tlamac�es, costs. <br /> / expenses. or cawes of actior. that may .�nse because ol installation <br /> ����� /� �- and maintenance of �he improvement or olner �igh4ol�way use here�o <br /> pp vp tor nstructio ate applied for and lur�her agrees to remo�e same upon no�ice from �he <br /> / � City and�o rep�acc public property damageA thereby. <br /> /7 i � 9 � /� / <br /> l � . ��/-</;/ n � ,� _�— <br /> �1r• -� �z � �.t.,,%-:= �i� - /_ _� �> <br /> FIN L INSPECTION � r � Datc � ��-� �� d <br /> Approvetl as Constructea Slgnature ot App�can� Da e <br /> everrlt PUBLICWORKSDEPARTMENT �NORK AUTHORIZED BV THIS PERMII MUST BE STARTED WITHIN <br /> � 3200CedarSireet 180 DAYS OF DATE PEnM!T IS ISSUED AND THEREAFTFP IS TO <br /> EveretC WA 99201 BE DILIGENTLY PURSUED TO COMPLETION THIS PERMIT MAY BE <br /> Phone:259�8810 CAN�F.LLED BY THE CI7Y UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJ[CT OVER g0 DAYS DURATION. <br />