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oa��'s <br />' Applicatlon For <br />PUBLIC `JVORKS PERMI �' <br />Print or Typo Only <br />� <br />iPo/ �� a✓, sr M.ill►'cGF <br />nu Atldreen City I�p <br />5 m nn � a J ct 1� v J_! __ __ <br />Appllcent Moillsg AAdress City TiP <br />Fun�ir WnrF� Permil • �� (� <br />Bia9 Dapl • �1/ <br />Publ¢ Worlu Fo <br />ToblFea / - � <br />leu �OP� Fsw P�IC � /1 I <br />BebnreouN d ^�'L��J <br />�� 9a�� " ; <br />i <br />�/ao�s. ? I I ,� nl <br />PhonP V <br />Phono <br />Deecribe Propoeed Worh _�.,atetr .� �! �'-� �d M — <br />Pro�aclAddreselilknownl �2�—�n��h ��� -S'E. — — <br />Atlar.h low (4) copias oi plene br p�oposed work � Drew lo scale and note ii�a loilowmp pa epplicable�. <br />• Property Llnee <br />• Outline end dlmeneions of ell axietinr� and <br />proposad eVuclares on Ihn lo� <br />• Ealaling and proposed utihtiea <br />Approved <br />PERMIT CONDITIONS <br />• Cenlerline of streel <br />• InAicete Norlh <br />• Shuw eny proposod prading r,h�n�7es <br />• Show meesuremenls <br />LIN <br />I. All cells lor inspecticn shall be mede 24 his. in ndvance � uhone 259•8815 <br />2. All worN ahell be� pertormed In eccortlnnce with this pe�mit and cwrenl Cily r.� Cverett Design end ConstiuUinn <br />Slnndarde am'. Speallcatione. <br />3. Call locellon UrCcrground Service 4U hra, belcre you dlg. TOIL FREE NUMBER 1•800•424•5555. <br />� c�ri s r� �v� l�j�fc,• To L'E" .nFmo rE v f!'� '� <br />�'�t> ��Tv • ��j c,•r:,C.��r .�Te.cFlv<�DS <br />FINAL IhSPEC710N - ` <br />ApproveA es Conslructed <br />e�p�p�� PUBLIC WORKS DEPARTMENT <br />� 320G Ceder Sireel <br />Evere�t, WA 98201 <br />Fhane�.259�8A15 <br />�C'Fcc��siv <<� <br />ncKr�ow�EncfnnrN� or co��oinovs <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />0 <br />a <br />Tho nnAer ,iq�,�d owne�/BpPlicent herebY Pfl�Pes!o hUTA and save harm� <br />------- ---"" -- b�ss the Cny nl F.vereU Irom eny and all claims for Aamng��s. rosts. <br />eapenses. or causes c� action ihel mHy en6e bec2use o� '.n ;.�Ila!ron <br />/ and m2mlenance ol !he �mprovement or O�her n�hl-o�-w:ry �is� herrlo <br />' nppGnd br end lurther egrees to remove seme upon n'Nn:e � om Iht <br />�, B�Q City and �o replace public propertY tlemegeA ihereby <br />�t' /O .�1— <br />— _-- Date! <br />WORK AUTHORIZEU BV THIS PERMIT MUST BE STAFTED WITHIN <br />180 DAV:� OF DATE PEFIMIT IS ISSUED AND THFREAFTER IS 'O <br />BE DILIuENTLV PURSUED TO GOMPLE710N. THIS PERMI7 MAv BE <br />CANCELLED BV THE CITV UPON AN'/ STOPPAGE O� WURK �N THIS <br />PFOJECT OVER 90 DAVS UURATION. <br />