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Date 7-9-90 <br />Applicetlon For <br />PUBLIC WORKS PERMIT <br />,� A�cT�p,G <br />Print or Type Only <br />PUEbr. Wer1� P�rmrl • <br />aiaa o�o� . �/ 5060 <br />PVUIIC WOIM� FN <br />TotU Fee � <br />le�� �ppi ine P��a S <br />B�bnce Oun i <br />W. A. Onveen inai _�rti e ctio fr o8108 ,��� <br />Ownar Mell�ng pddress C�ty Zip Phone <br />Applfcant <br />Desc�lbe Propoead Wo.k <br />Pro�ect Addreen �il known) <br />Additian <br />Atldress <br />Cily Zip Phone <br />Attech four (4) copibe ol plane lor p�oposed work - Drew to ecele and nota Ihe lollowing as applicable�. <br />• Proparty Linae • Centerline �f alreet <br />• Outline end dimenelons ol ell axistinp end • Indicete North <br />propoaed atrucluree on Ihe lot • Show any propoeed grading changes <br />• F.xleting and OioPoead utllitlen • Show measurementa <br />PERMIT CONDITIONS <br />1. All cells lor Inepection ehell be mede 24 hre. in edvence • phone 2BB-8A10. <br />2. All work ehell be perlo�med In eccordence with Ihis permit and currant City of Everelt Desipn end Construction <br />9tenderde and 3paclficetlone. <br />3. Cell Locaflan Underground 3ervlce 48 hre. before you dig. TOLL FREE NUMBER 1•800-424•55li5. <br />i��//3Y i'i C,r/o�� /PQ�:I- /%�o�` .Cn�.c.��..r� <br />���.�� <br />� q _9�� <br />� <br />Approvad for Conetruction Dele <br />FINAL INSPECTION <br />Approved as ConetruciBd <br />everett PUBLIC WORKS DEPARTMENT <br />� 3200 Cetlar 9Veet <br />Everall WA BB201 <br />Phone'259�8810 <br />Date <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />The undersipned ownxr/epP��cenl he�eby egreea to hold and aeva herm� <br />leas Ihe Cily ol Everett Irom eny and all ctaims for tlemegas, coets, <br />eMpenses, or ceuaes of ection t�al mey erlse because ol Instelletion <br />end mnintenence ol lhe �mprovement or other nyhLobway use hereto <br />BppGed br end lurlher agrees to remove aeme upon notice trom the <br />Ctly enc7 to �eplacr pu6lic property tlemeged thereby. <br />Slgn.gt�re ol Appllcant �ete <br />rYOFK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEFEAFTER IS TO <br />BE DIUGENiLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITV UPON ANV STOPPAGF OF WORN ON 7HIS <br />PROJECT OVER 90 DAVS DURATION <br />