|
D a te _�ls�$�%
<br />nl�phr'nli, � 1 nr
<br />PUBLIC WORKS PERMIT
<br />Print or Type Only
<br />�„�,,, w,,,�,��,.,�,,
<br />�.,,i,� n.w . if ��c� 1�l SS'
<br />, ,,,,,., ,�: ,.. � ,..
<br />��„ �..,, s . - ------
<br />�,.., A,,,• ,,,, �,.,,� s - --
<br />�,,.,,, .�, .
<br />� c I�._.A N�IP., 7i,,�- / S i(�_.fL_��tf k�i¢ �A zo9- 3y� -�/ya �1
<br />Ownei �_ Maihny Atltlnrss l:�ty Zip Phnne
<br />�
<br />�rrmA-b.�-l-�--L(n��L/�,�h�ay ��l- _ �}���n wa�_ 4 �0.31 _7��.�.i�__-- —
<br />Appl¢qnt Mnilmy Adc ��ss CiH Lp Phonc
<br />Descrihe ProFosed Work __.���f..�.____{,f�'/lC�j � . - _
<br />�� !
<br />Pro1ec1 AAAress Id knownl _—��-
<br />At�ach lom IA1 coP�Ps ol pinns Im ProPosed work - praw In sr;d�• antl nMr, ihr Io11UWmg PS ApPhCebIP.
<br />• Property Unr.s
<br />• Ou��i��P enA Aimensions o� all esist�ng anA
<br />propnsvtl 5lructure5 On Ihe lot
<br />• [Mishnq ,�nA propoSeA Ulililirti
<br />� Cf�IPIIiOP O� 91fCP�
<br />• Intlicole Narlh
<br />• Shnw anY Pruposed y,�Ain�l �h�ncl�'s
<br />• Sh�w m���5urernFn�s
<br />PERMI7 CONDITIONS
<br />1. All calls for inspeclion shell be made 24 h�s. in advance � phone 259-88i0
<br />2 All work shell be perlormed in �cco�dance with ihis pe�mit antl currenl C�ty ot Everetl Design and Construction
<br />Sinnderds nnd Sperfications
<br />3. Call loca�ion UnAerqn�� nd Service 4H hrs Uetore you diy TOLL FREE NUMBER 1•800•42�i-rJrJ$�J.
<br />lor ConsVuc�ion
<br />.��
<br />�.� �, ����
<br />FINAL INSPECTION
<br />ApP�oved a5 Conslrucled
<br />rvrrr�ll PUBUC WORMS DEPARTMEN�
<br />� 3200 Cetlar Streel
<br />Everetl, WA 9920'
<br />Phone 259�8810
<br />�CMNOWLFDGCMFNf O� CONDITIONS
<br />W
<br />�
<br />�
<br />H
<br />�
<br />O
<br />a
<br />The untl�rsiqnetl own�r�pnh�an� hrrchy ayrees lo hulA nnA save harm�
<br />less Ihe Cdy ol Everett Irom nny and all r.laims for damayes. cosls
<br />ewpenses. or r.auses o� xcUon Ihal mny anse because ol mslallalion
<br />2nA mainlena�r.e nl �he improvement o� olhe� nghl�ol-way u5e here�o
<br />— applied lor and lurlher agree5 lo remove 50me upon notice Irom the
<br />���P C�ly anA lo �eplTce pubhc property demegrd Ihe�eby.
<br />D��t
<br />Signalu�e ql ApGlir.anl
<br />WORK AUTHOR12ED BV THIS PERMIT MUST BE STARTFO WITHIN
<br />180 DAVS OF DATE P[RMIT IS ISSUED AND Th1EREAFTEF IS TO
<br />BE DI�IGENTLV PURSUED TO COMPLETION THIS PERMIT MAV BE
<br />CANCELLED BY THE CITV IJPON ANY STOPPAGE OF WORK ON THIS
<br />PRf7JFG1 OVEF 90 DAVS DURATION
<br />
|