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DatF� ��u 1 <br />nnriu�,ii�rn ! ar <br />PUBLIC WORKS PERMIT <br />Pnnt or Type Only <br />�..�,i�� u�n� . � 1[7lcJ�V C�Q <br />,,,�,�: w�,,.:;.., <br />,,,,,,.,. : - _ <br />,,.,,.�,�. ��.��:,.� s _ ------ <br />�,., . ,. ,. �, ,, • - — <br />��3�1Q_� _�►�'��5_ P�t�v� - - --- ------ - - <br />qpph[Bnl Mndmq Addmsr; C�ry. . 1ip Phane <br />D�,scaibeP�oPosedWork �I, � .-_. _ �jC �LS..��1� J/ __._ <br />� � / �___ <br />_ I� --/�--�- - D__- -GT--- ------ <br />Rniecl AAdress Id known) ��.—�L--�La./ --- .—`--�....�i�-- . . . . <br />Altflr.h luw 141 coU�e6 OI pIBnB (Or proPoSP.tl work - D�d�•. In si dlr• dnd np�n Ihn Inllnwiny ,�5 apphr.pbh. <br />� P�OpP,��y lI�ES • Cenlrrlm� nl Slrecl <br />• Ou1hnN nnd Am�qn9�on5 nt all pv�simq �nrl • Ir�di� o�r Nnr�h <br />proposrA 51rur:lirtes an Ih�� Int • Shuw aiiy nrnpptie�A yi.�qiny rhanqes <br />• EHisi�ny anA propn5vd u�iliprs • Snnw mrdsuremPnts <br />TF Hf. I OW IHIS l INF <br />PERMIi CONDITIONS <br />1 nll calle br insvection ahall be made 24 nrs m edvance � phone 259•8810 <br />? All worM shell be pedormed in eccordence with Ihls permit anA r,wrenl Cily ol Everett Des�gn and Construr.lion <br />Slandards and SpFcihc.tli0n3. <br />? C�II I ncn�ion Undr�nround BNrviGe 48 hrs belnrr� you diy TOLL FREE NUMBER 1•800•424•5555. <br />r <br />APPrnvqd 4,� l.nn.�.bu� li���n <br />FINAL INSPFC�I(.-IN <br />Apprnved .l5 Lunstru� IHq <br />rv�rtrtl PUBLICWORHSDEPARTMENT <br />� :200 CeAer S�reet <br />Everell WA 99201 <br />Phone 259-RHIu <br />� <br />u <br />� <br />� <br />�w <br />_ / <br />� <br />a <br />..�. rFA��:Sllli,�lr�f':I ��i �. ��.Glf�rtli�nlr; <br />.. ,,.ndrr .iyn�•n rn•. nri aLnb� ,P�� h�,���by .lyme�ti �n hulel [3nd s��:�� h:n��� <br />i•��.�. 1he Gly ol Everett trom any anA all r.la�ms lor damages. cosls <br />��•�+�•nses. or r,auses M ar,lion Iha� maV arise becnuse ol insiallation <br />:mtl mainlene�r.e of the improvemenl or o�her nghl�of-wey use heretn <br />npphed lor and �urlhe!r Aprees to remove snme upon no�ice Irom thr <br />Gly and lo replace puhh��. pruperty tlamageG Ihereby <br />S�qnatwe ol APDlir.nnt Dale — <br />WORK AUTHORIZED BY 71iIS PEFMiT MUST BE SLARTED WITHIN <br />180 DAVS Of DA7E FERMI� IS ISSUED AND THERFAFTEF IS T(� <br />BE DIIIGENTLV PURSUED i0 COMPLETION TMIS PENMIT MAV BF <br />CANCELLED BY THE CITV UPON ANV STOPPAGE OF WORK ON THIS <br />PRC�,�ECT OVER �0 DAVS DURATION <br />