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Date -� Z -t <br />ppp�icanon Foi <br />PU�LIC \IVORKS PERMIT <br />Print or Type Unly <br />A , <br />Pu1�i�c Wnr�e Pnrmrrril •��' `� � L� i— <br />Bitlp �vo� � � � � <br />Pueim Worw� �a� 6' j.p• p O <br />Tol�� Fse <br />lree AO�I fee Oeid s_ � ' <br />Oeie�ce oun s 7Q �p � - <br />— goyden ReultY, Inc. 1429 Broadwav Gverect _ 98 0�_2��-1166 <br />Owner MelhngAtldress City Zip Phene <br />Boyden Renity,Inc. <br />dba J 6 D Buildere 1429 R*nadway Everett 982J1 252-1166 <br />Appllcant Meil����aAddreas City ZIp Phone <br />Desaibe Propoeed Work ��.QYl'L–�17,� R�s1�1rlL:k' -- <br />ProlectAddrese�lll.nown) _�1i7...=�5�� plarP S_1•,� Rvnr�rr _--_ <br />A�tech lour (4) cople9 of plaus lor proposed work � D�aw to scale and note the lollowinp as npplicabtr� <br />• Prope�ry Lines <br />• Oulline end dimonslons ol all existing r nA <br />p�oposad etructuras on Ihe lol <br />• Exisling end proposed ulilities <br />• Centarline ol slreel <br />• Intlita�e Nor�h <br />• Show eny proposed [IraUinn cnangcs <br />� Show measurements <br />P[RMIT CONDITIONS <br />1. All ce�ls lor inspaction ehall be made 24 hrs �n edvance - phone 259-881 5. <br />2. All work ehell ba pa�lormed In aeturdance �� dh Ihis permit an� currenl Clty ot Lveretl Deslyn Fnd Construction <br />Slenderds and Specitica�ions. <br />3. Cell Lor.3�ion Jnderground Service 4A '�rs bebre y�u di9� TOLL FREE NUMBER I•BOO•424-rJrJSS. <br />��— � — <br />_ ��,�.�� �/�� .�� <br />,App ove for Cons'�uction Dete <br />� � <br />!� I.E?`��' ������, � <br />F;NAL INSPEGTION ete <br />'�pp�oved es Cunslructed – l <br />��e��ry PUBLIC WCFlKS DEPARTMENT <br />� 3200 Cedar Slreet <br />Everr,�L WA 98201 <br />Phoce�.259��815 <br />ACKNOWLEOGEM:N7 OF GONDITIONS <br />W <br />� <br />�w <br />_ / <br />� <br />O <br />The undersig�ed owner/npplicanl hereby egrees lo hold and save hxrm- <br />less ihe City ul Everett Irom any end all clelms Por damngos, costs. <br />eKpenses, or ceuses ol ection Ihet mey arisn beceuse ol Installetion <br />and meintenence ol Ihe improv�rment oi olher righl��'�wey use here'o <br />applied lor end Wrther agioes to �amove same upon notico Irom the <br />City end to replace public property,demeged Iharaby. <br />/ <br />�����( : �Ai� � � � i( ��L V ��' � �� � � <br />Siyneture oi Applicanl Dn�o <br />VlORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />1B0 DAYS OF C�ATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE OILIGENTLV PURSU[D TO COMPLFTION. TNIS PERMIT MAY BE <br />i,ANCELLED B� THE CITV UPON ANV STOPPAGE OF WOqK ON THIS <br />PIiOJEC �; OVE R 90 U!.'.B DURATION <br />.. �. <br />--1 �i <br />�-.� y <br />V1 2 <br />f�l <br />v <br />co <br />mo <br />-i c <br />0 <br />-� z <br />x -i <br />m <br />.. <br />o z <br />cy <br />r � <br />< N <br />T <br />O A <br />� �--1 <br />x <br />m� <br />� <br />r <br />c� m <br />f� N <br />� <br />Z C� <br />-i r <br />. m <br />a <br />.o <br />-� <br />2 <br />S� <br />2 <br />3 <br />V <br />_ <br />f" <br />