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� i �I z �.� <br />Dete 5-95-92 <br />Applicntlon For <br />PUBLIC WORKS,�F,j����G �.,s �� <br />r�� _ <br />Print ar Type Only <br />Pu�ec Worhe Fer�m�n ��p_�� V� �, 1 <br />Bi�lp �en� � �_yy2C_ _ <br />iee <br />f0��1 F�n • <br />lea��oPl faeP�iE i <br />7 <br />B�'-�cenie i L.�—� <br />November Partnerehip 22702 66th Ave W Mtlk Terrece 98043 775-5297 <br />Owne� Mai4nQ Address CIIY Zip phone <br />Rose Woodward Conet. 8606 Caecadia EveretC 98208 331-4003 <br />Applicanl Mailmg Address Cny Iip pnone <br />Deacribe Proposea work houee move and placemen[ <br />Prolect Addresa (il known) <br />Atlech lou� (4) copiee ol pinns lor piopused work � Drew lo acale aatl note Ihe lollowing ae applicable�, <br />� Property Linea <br />• Oulline end dlmensions ol all axisting and <br />praposed elruCiwas On Ihe lot <br />� Exlsting end proposed utilities <br />• Canterline of sVeel <br />• Inditate Norih <br />• Show any proposed g�eding changes <br />• Show measurements <br />PERMIT CONDITIQNS <br />1. All calle for In9pection ehall be mede 24 hre. in edvence � phone Z5Q•88i0, <br />2. All work ehell be peAormed In eccordence with thla pe�mit end cwrenl City of Everett Deslgn end Conetructlon <br />3tendarde end Specillcatione. <br />3. Cell Locetion Underground Servlce 4B hra. befo�e you dig. TOLL FREE NUMBEF 1•800�424•5555. <br />4• 1 Cti+x�C C� Y" � J,f v cwl <br />�-rr,��p.r � 11�,-� <br />d?;�1�+ -��'-..�a,.� <br />�� �� <br />. �����n�;��_ <br />,... .� �� a ���.. (-�' � e {.w-ecti� <br />� c>cl rjf .y �J2..�-Y v�.oi.i � ,�'� <br />�-,t�—iZ <br />ApproveA,le��onatructioP , Dal <br />/v ' Q Y/ � <br />�L�EC�� � , 6/ Dete <br />App.nved es Construcled <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />� <br />� <br />O <br />� <br />� <br />0 <br />a <br />The unda�signetl ownr,r/epplicant hereby ngrees lo hold and �.��ve hnrm- <br />less Ihe Gity M Everelt hom any e all cleims lo� Aame9es. rosls <br />e�pensr.5, or ceuses af ectlnn th mey ari9e because ol mslallaiion <br />end mam enence of Ihe improv ent or olher nclht-n4way use hrrelo <br />epplied r end luriher agrea o remove 68me unon nobre Irom Ihe <br />Cily a rAplaqe puhlic pr grly demxged Ihereby <br />m <br />Ii <br />b <br />��te <br />�PUBIICWORKSDEPAHTMENT WORK AUTHORIZE� THIS PERMIT MUST BE STAR7ED WI1V71N <br />3200CederStree� 1B0 DAVS OF DAi ERMIT IS ISSUED ANO THEREAFTER IS 70 <br />Everetl. WA9B201 BE DILIGENP_Y PU UED TO COMPLFTION THIS PERMIT MAV BE <br />Phone 259�8810 �ANCELLED BV THE CITV UPON ANV 6TOPPAGE nF WORN ON iHIS <br />PRbJECi OVFF 9Q DAVS OLIFATION <br />