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Dat� �� <br />Appllcetion Fnr <br />PUBLIC W4RKS PERlV�IT <br />Pnnt or Type Only <br />ownar <br />Applicent <br />Deecribe P�opoeetl Worn <br />� <br />Projact Addn se Ilf knownl �� <br />P�� � Wo,.. F.,... .! � U � — /y9 <br />Bi�y DeDt � _ e^G'�/—��� <br />o„en� won� rne <br />Tolp ioe f <br />Leu �OC� f�e Putl i <br />P�I�np Oue f ��� <br />Lp <br />7�U <br />-/O(o==' . Si: ,S: E <br />Atfach lour i il coples ol o�ena lor proposed work � D��w lo scele end note Ihe Iollowing as eppliceble <br />Y Prooerty Lines <br />• Oulline end dimansions of o�� eeieting antl <br />proposed sUuClurae on Ry u I <br />• Exi511ng end p�opoeed u116h ��e <br />PERMIT CONDITIONS <br />• Centedine ol aVeel <br />• Intllcate Nortn <br />• Show any propoead grnding changes <br />• Show measurnme�ls <br />1 All cells lor inspection shell be made "4 hrs in ativence � phone 259•8815 <br />2 All work ehell bn perfo�metl in eccorc nce with thie permlt enA currenl Ctly o� Evereu Des�gr anA Gonstrurhon <br />Stenderde end Specificelion�. <br />3 Cell Locu��on Underground Servir.e 48 hra befora �ioo d 7. TOL: FREE NUMBER 1-800•42d•5555. <br />4. ANY GNADING DUNE UN THIS IAT SHALL BF, DOf1E SO AS NOT TO IMPACT THF. <br />SURROUNDING LOTS WITH RAINWATER RUNOFr', <br />5. ANY CUR� & GUTTER OR SIDEWA�K UAMAGED DURIN� CONS'PRUCTION SHALL BF. <br />REPLACED BY THE APPLICANT. <br />�--'.'_���'c+�'�� ,��`�'G. <br />Approvetl lor C6ns�c n ale <br />L/'c�� KY'1�/IiJ^G—_ � ' �(.�'�1 �+ <br />FIp1AL IIvSPECTION \_ Dete <br />Approvetl as Constructec' � <br />rvrrrtt PUBLIC WORKS UFPARTMENT <br />� 3200 Cedei Slreet <br />Fverelt WA 98201 <br />Phone�. 259�BB15 <br />ACKNOWLEDGEMENI Of CONDITIONS <br />W <br />� <br />� <br />The imdertiflnatl owner/epplicen� hereby agrees lo hold end snve herm� <br />less Ihe Cily of Evarxtt Irom eny end ell clalms lor damages. costs. <br />e.penses, or causes ol echrn�. ihet may ense beccuse of Inslellation <br />end memtenence ol the Improoament or other nght�o4wny use hureto <br />applieA Ior Bnd lurlher egraes lo remova seme upon ��olice Irom Ihn <br />Ci1y end lo rep�ece pubhc property dameged ihereby � <br />WORN AUTHORIZED BV THIS f�ERM1T MUST BE STARTED WITNiN <br />180 UAVS OF DATE PFRMIT IS ISSUED AND THEREAFTER IS TO <br />BE OIU�iENiLV PURSUID TO COMPLFTION THIS �'FRMIT MAY BE <br />CANCELLED BV THE CITY UPON ANV STOPPAGF UF WORK ON THIS <br />PROJECT OVER 90 DAVS D�JRAiION <br />