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11/20/B4 <br /> D8t@ Pum¢won�^s,mn• L�S'�1_ <br /> Appllcetion For B�ao o�ot�_adJld'69 <br /> P'UBLIC WORKS PERMIT �������W����„ <br /> ITeMIF�1 , <br /> .�.,eooi ro P.�a • <br /> Print ^�r Type Only e.�.��.o�. s 29�.�. Sa� <br /> Pioneer Propertice <br /> Owner Muninp Address City Lp Pnone <br /> ,r/M . Gaffney General Contractors, Inc, 3324 Spruce Everett 98201 � <br /> ...��j. 7i'/ S� <br /> ApplleBnt Mailing qdd�eee Clry Zip Phone <br /> Conatruct Coruneccial 8C Office Building <br /> Deecrlbe Propoeed WorM __________ <br /> Pro�ect AAdreee pl known) /7/c7 -_ /!>���'�' �j ���_ _ � <br /> Altach four(4) coplen ol plane for proposed wo�k� Draw�o scele antl nole the following ns appl�.cable � <br /> • Proprrty lines • CenterLne M street � <br /> • Qullina end dimenelons ol ell ewlelinp end • Indicete North <br /> prupueed etructwes on the lot • Show any proposed gradmc -tianqes <br /> • E�iehny end propoaed utilitles • Show mea5uremems � <br /> DO NOT WRITE BELOW iHIS LINE �_ <br /> PERMIT CONDITIONS O <br /> 1. All calla lor inepection ahall be mede 24 hrs. In advance� phcre 259•8815 � <br /> 2. All work ehall be perlormad in accortlenca wlth Ihis pe�mit and current Cny ol EvnrPtt D^siyn flntl C0�5�ruclion <br /> StenAarde end Speclllcetione <br /> 3. Cell Locetlon Underpiound Service 4B hrs. bebre you dlg. TOLL FREE NUMBER 1•800•424-5555. � <br /> ;� P•C'e�,7L"7: Tt� [�E Cevp'STa.'vLTEU LiS /�E.t !'e�,n/S O <br /> AP.�,eovE-U A.vU 04TE0 /-�'3_ h�s <br /> S D,�{-SirE SEwt�,E� �fiini fXTEn.�s.rr,V T� h'L � <br /> Cc9.VST,c•tYTEO /'E.e f1�acHEO SKc�rCiY. � <br /> 6. A /�.Ei�•.nrfc [i pw,vEO /N,f/. SHec� p•E I.cu�JctEO O <br /> / <br /> AT TiSiE P,c�Of�E.eTy L/�/E ��,e T,�AuS��iuN f"j���„� � <br /> �'�i'��GT� P•t'E�slf3w+l�,eTr� I'Ul�..�c G,�A✓.T(/ L/it/E. <br /> / <br /> 7 �f%-'uce�.�7 r.t,'�1� ,BE� .�'fc;u�.eE� TO L.�.vsr,����cT lTFh�S <br /> %�f.e S.E./.'A, i/�a-� /.,iyicN MAy.C�nT dE �cTFO ON /�ct��'-S. <br /> ACKNOWLE�GEMENT UF CONDITIONS <br /> The undrrsigned uwner;epPhcent hereby agreea�o hold entl save herm� <br /> lees 1',e Ciry o! Everell Irom any and ell cleime lor demegea, coeta, <br /> , �?rpenses, or causes ol ectwn that mey arise becausa ol instnlletion <br />� L� � �—„�73.� ¢.nA maintenance ol the Improvrment or other nghFobwey uee hereto <br /> Ap ro ' nstru � n fipPlied lor end fur�her Bgrees lo reniove eame upon notice Irom the <br /> . Dele ;;����anA to rrp'.^.ce public proPArty demegnd thereby. <br /> i <br /> I U I�s' ( � > � — <br /> PINAL IN � CT ON Dete — "" ���._ <br /> Approved es Constructed � Sig ature o�App1 .anl � Gele <br /> everptt pUBLIC WURKS DEPf�RiMENT W Nh AUTHORI2FD BV iH S ERMI MUST BE STARTEO WITHIN <br /> � 3200 Cader Sireel � � �A�S OF DATE PERMIT IS !SSUEG AND THEHFAFTER IS TO <br /> Evaretl, WA 98201 BF DiUGENTLV PURSUED TO CJMPLETI�7N. THIS PFRMIT MAV BE <br /> Phone: 259�BB15 CANCELLED 9V THE CITV UPON ANV STOPPAGE OF WORN ON THIS <br /> PROJECT OVcR SJ DA15 DURATION. <br />