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Cu4�¢Wnr�f Pe�mn• ����I--- <br /> Date�=.�� <br /> ~ Biey Oeo� � - — <br /> App�icetion Fo� <br /> PUBLIC WORKS PEFiM9T �����C PUE��cWorM�Fea ��e �'— <br /> 1�1 F�e <br /> �� L.(."�}� �eo�oM ue f a U. � U <br /> B�I�ncs�ue s �n' L�---- <br /> Prinl or Type Only <br /> .3.�7 �oJ.��� <br /> �. �Evi� W{�{ �210`0 5�4tf� k11�� (zp �Mett 4i�290 33o?boy o <br /> 0,�,�Q1 Meiling Address ���Y Z�p -..� <br /> .. <br /> !n <br /> f �'�lE S�RkA'�f.l !�N 1b25 S�/h544�n1GhJ �'�L..� INA q�o5 1�1�-8bS"] :.^ <br /> Appllcanl Meiling Address ily Lip Fhona <br /> ..r.. <br /> � y �.�1, / -1 TI <br /> � �1, �{,�?G 0���r. /.A,+ e�ff�� �d.T�. yL lP l ��w�Ll�-�— .,-� <br /> DeeCrlbe PropoBBA Work f � _ <br /> � / m <br /> S� �L�.N�f S(n6/ ��illC_ d /L/� ___ CC <br /> �end�,,6 w�� � `-�___ �"� ', <br /> -�c <br /> oz� <br /> �� � v - :—v,� sr �,�_ — W �z � <br /> soufld �F _c,x��. o � � ` S� �?. ��E � �-- _ � <br /> m <br /> Prolecf Addrees(if known) -- q z I <br /> Attech lour I<I copiea ol plene lor proposed work� D�aw to scnle a��d note Ihe�ollowing B5 epplicable�. � y � � <br /> • Centerllne ol etreel ��� � � <br /> • Proparry Lines • Indicale North V� "'��^ <br /> • Gulline end diman6ions ul ell eaishny anA <br /> proposed etrutturBe On the lol • Show any p�opo9ad gratling chenyes � �i <br /> • Show mexsuramenls M �� <br /> • Exislln0 end proposed nlllifies W <br /> ��, <br /> DO hJT WRITE BELGW THIS LWF � m�. <br /> v <br /> PERMIT CONDITIONS <br /> 1, All cells lor Inspection s`vll he madn 24 hrs. in aAvnnce� phone 259•8B�5. ^ � �' <br /> c v� <br /> 2. All work Bhall be perf�rmed in acCordanr.e wlih Ihis permit nnd curtenl Gty ol Everett Design xnA CnnStruclion r m�, <br /> Slenderds end Speciilcationa. � _ �' <br /> 3. Cell Locelion Undeipround Service 48 h�s bafore you dig.TOLL FREE NUMBER 1•80Q•424•5555. -+r <br /> � % � � n <br /> '� n p�045 �O/L'L"t d ?n � � ���� � <br /> J"-�v ,/ �r j, , , O s <br /> r <br /> � <br /> � <br /> . �.f , � .. - • � " <br /> � <br /> O ( <br /> a <br /> ACKNOWLEDGFMF_Nl OF CpNDITIONS <br /> Thr imder.;igned nwncN�nplir.qnl herehy aB�aes lo hold and save�erm� <br /> — r —�- --___ .._ . <br /> �� - -� -- �-� Iess Ihe Cl�y Eve�e�I Irom any end ell cl0�me lor demega5, tosts. <br /> / �' expenSee, or ta es o� ��:hnn Ihe� mBy erise baceu5e ol Inn�elletion <br /> l i� �� and mel I e improvamanl or olher nghl�oFway use hereto <br /> .',�-. app for nd W r ey es to remove semn unon nolice hom Iha <br /> 11�proVBd lor fl�li n i .•" �B�P CI� end�o apler. b�ic p oparty demaaed ihe�eby <br /> � vVL o � <br /> �z�-�_ <br /> fINALINSPECiION ����`� � � <br /> AnP�oved es Conatructed <br /> Sig Wre ol pPticeM (�)PIP <br /> W K AUTHORIZEG BV TI115 PERMIT MUST BE STARTED WITHIN <br /> v.,,p�P�� PUBIIC WORKS DEpqRT ENT 1 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200 Cedar Sireel BE DIUGENTLV PURSUED TO COMPLETION. THIS PERMR MAV 5F <br /> [veretl WA 98201 CANCELI.E�BV THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br /> Phone 259�8815 pROJFCT OVER 90 OA�S DURATIf�N <br />