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Ilr..; <br />��R 2/ia/�e <br />Applfcatlon For <br />PUBLIC WORKS PFRMIT <br />Prin1 or Type Only <br />VUCIk WatM� Pamp � _ ��' �" � <br />eieo om� • <br />we�k won. r.• _- <br />roln Fwe f <br />Leu �Do�. F�� P�iG e�� <br />P ��cabue { �� <br />, F:etco Constr��ctlu�, 17U1;, 1Sth f.v.�nu., 'I.f'. e:r•Zt.t.lc yrt r <br />7�� 3G3-0316 <br />Owner MelNng qdd�eaa Cfty 21p Phone <br />��un� <br />Appllcanl Mailinp Addrnee City Z�V Phone <br />Deeeribe ProDoaetl W��k <br />l.ot 25 <br />Construct �in�:le 1'amily Re51:7enc� <br />Pro�ect AdCraee pl known) J ��' /� —/�' �� v>' �_ <br />Alfech four (4) coplee ol plene for proposed wmk • Drew to acele end nofe the lolinxing ea epplicab!n� <br />• Property Llnee • Centerline of ,�freAt <br />� Oulllne end dlmEnsione of ell axletiny and • Indiente Norlh <br />propo:ed elructurea on Ihe lot • Show eny prop�ised gradmg changes <br />• Exleting end propoeetl ulilitiex • Show meaeurements <br />PERMIT CONDITIONS <br />1. All celle for inepection ahell be meAe 24 hre. In edvar. e- phone 259•881 5 <br />2. All work ehell ba pe�lormed In eccortlence with thle permil end current Ciry ol [varPti Design and Const�urlion <br />Slenderde end Sper111cetlone. <br />3. Ceil Locelic n JnderprounA Service 48 hre. bafo�e you dig. TOLL FREE NUMBER 1•800•424•5553. <br />�� , <br />C <br />� <br />�" <br />� <br />��NJ r G�.�.�Vo � <br />(.Yt.. �� ( . �� . <br />C% <br />r � i <br />4�a,�^-.�4-I .-�._[.J � w�(y'l�7I�. <br />) <br />- �� 1ii."- % ' . . / ..-i /--Ir 'Y y'�.. <br />Approved for Conelrucllor. � ��— <br />��`�.}� < ZJ <br />FINAL INSPECTION Date <br />Approvad es Conehuctad � <br />everett PUBLIC WORKS DEPARTMENT <br />� 3200 Ceder Sireet <br />Everefl, WA 98201 <br />Phone�,259�B815 <br />ACKNOWLED(3EMENT UF CONUI710N5 <br />The unAersignad owner/applicenl hereby egrees I i hold nnA snve harrt�� <br />Ie98 Ihc �Ily ol Evernll Irom eny end all cleims for dnmayas, r,osis, <br />ezpensae, o� ceuses ol ection the� mey eriae because ol Installaf�on <br />end mainlenence ol �he im�rovement cr olher righPof�wey use hernto <br />epplietl lor ena lurlher ayrea: lo remnve seme upon notice Irum R.a <br />Cily end to rep�•^e�abi�, o�ia�ty dameyed Ihareby. <br />/_ s _-//�'/ --- <br />, <br />� � <br />. <br />Signqlure o� Apph�anl Dale <br />WORK AUTHORIZED BV THIS PERMIT M T BE STARTED WITHIN <br />1P0 DAYS OF DATE PERMIT �5 ISSUED ANU THE:REAFTER IS TU <br />BE DILIGENTLV PURSUED TO COMPLETION. THIg PERMIT MAV BE <br />CANCELLED BV THE CITV UPON ANY STOPPP,uE OF" WORK ON � HIS <br />PROJEC7 OVER 90 DAYS DURATIOh <br />