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i <br /> ` �YS-.�87 <br /> Date P,.m�Wo�x�Permn• <br /> ' � S� �q <br /> Appllc9tion For B�au oeoi • <br /> QUBLIC WORK� PEl�M IT P°^���W°��,°°. <br /> tol�lfee � <br /> Lef��p01 fea PUJ � <br /> B�ience Oua � �s'�G <br /> Print or Type Only Y/S�f <br /> � /� I � ,� �' ( <br /> �,�r� lzt+tnc ��a'1-c, �;AD-l39*N,,e .� �oka•.>s� ��o_ <br /> Owner Meiling Atldress Gny Zip Phone <br /> I�� �TJ �_ �lM�— _ <br /> Appll nt Malling Address City Zip Phone <br /> Deserlbe Propoeed Wo�k �r V�'�<< � �� <br /> _� �6rQ <br /> Pro�act Atldraes(II knownl �_��� � ����L��� � <br /> — � . <br /> Attech lour(4) coplee ol plene lor propueed wort� D�aw lo ecnle end nole the L,Ilowinp ea eppliceble-. � <br /> • Property Llnee • C�nterline ol etreat � <br /> •Outnne end dimenelonn ol all ezisting entl • Indicete North <br /> propoeed atructuree on the lot • Show eny proposed grnding changes <br /> b EMfetinp end propoeed ulllllias • Show meeswements � <br /> DO NOT WRITE BELOW iHIS LINE O <br /> PEPMIT CONDITIONS <br /> 1. All celle Im Inapeclion ehall be mede 24 hrs.in edvence�phone Z$9•$8�5. � <br /> 2. All Nork ahell be parformed In ecwrdenca wlth thia parmit and currenl C�ty of Everi�t Desig� end Conetructlon <br /> 31anAerde end Specflicellona. <br /> 3. Call Laeelion Undarg�ound Service 48 hre.halorP you d�g.TOL�. FREE NUMBER 1•800•424•5555. � <br /> TL' !�f fC���t�.l�c�cT1-�� �Fti' /�Gc�7 PtnnJ O <br /> S'c�Bi,a.l�Cc� OE�. i9 iS'.9'-s. <br /> � <br /> � <br /> O <br /> a <br /> A�KNOWLFDGEIAENT OF COND�TiONS <br /> inN unhNrs�gn�d nwner/eppticenl hareby agreea to hold end seve he:m• <br /> -- less Iha Cdy ol Everett Irom en� end ell clelms lor demegea, coata <br /> erpenses. or r,eusee of ecucn r�et mny arise beceuee ol Ineteltetion <br /> � ����'� ����_�S end melntenence o� the improvqmant m olhar rlght�ol-wey use hereto <br /> epplied �or end lurihar e8�ees Ic remove seme upon notica 6om the <br /> Approved for C ns ction Date Gty end t rpplece public propqrly demagad Ihereby. <br /> -- (Z �U -b� �'�//(� � <br /> FINALINSPECTION De�e � ��' C � �2�� <br /> Approvod es Construcletl Signelur ol AppHc � Dete <br /> rvPrrll PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BV THIS PERMIT MUST BE STARTEC WITHIN <br /> � 3200 Ceder Slreel 180 DAYS Of DATE PF.RMIT IS ISSUED AND THEREAFTER IS TO <br /> Everetl.WA 98201 BE DILICENTLV PURSUED TO COMPLE710N, THIS PERMIT MAV BE <br /> Phone�. ?59-8815 CANCEL�ED BV THE CITV UPON ANV STOPPAGE OF WONK ON TNIS <br /> � PROJECT OVEF 90 DAVS DURATION. <br />