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Date_ I I�� TO PO�TING...1" �� <br />APP�ir,�hon For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />n ,- �' <br />Pupe� We.\e Per �"// <br />Aiop Daol � ��'(]�`k�� <br />_� <br />Put•r�cWor4fea �---"—�'----'— <br />r�iar.� 6_ <br />lrse �no� f�r Penf � <br />n,�,,,,..rn�. t 70� <br />Applicent Ma�hng AtlAresa " � • �Q <br />CitY Gp Phone <br />Deac�lbe Proposed Work <br />Pro�ect Adtlieee �il knownl <br />�� � <br />Attach lour (4� copies ol plana lor proposed work - Drew to scale antl nola Ihe lollowing as eppl�cnble� <br />• P�ope�ty Lines <br />• Oulline end dimensions oi all exisling anA <br />proposeC atruclures on the lot <br />• E■isling and proposad ulilllles <br />• i;entarlina ol alree� <br />• Intlicale North <br />• Show eny propoeetl gietli�g changes <br />• Show n easuremenis <br />PERMIT CONDITIONS <br />1. All calle lor Inepeclion ehell ba made 24 hre. in advence - phone 259•8810. <br />2. All work ehall be peAormed In accordence with this permit end current Clly ol Everett Deeign and Conelrucllon <br />3tendarde end Specllicetlone. <br />3. Cell Locellon Underpround Service 48 hre, before you dig. TOLI FREE NUMBER 1-800-424•555b. <br />�u��M��� ii— i c� -�� <br />Approved 1 irucli n pfl�e <br />� / <br />FIN I f'EC ION � Da <br />Approved as Constructed <br />everptt PUBLIC WORKS DEPART,NENT <br />� 3200 Cedar Street <br />Everelt, WA 9820+ <br />Phono: 259�8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />The untle�signnd owner/applicanl hereby agrees to hold end save hern- <br />less Ihe Gty r,l Everelt Irom eny and all cleims lor damege� coats, <br />BMpCnS@9, Of CPu5P3 OI ACh011 (h31 RIAy 8/150 bBC8US0 OI IOS�dIIp�lOfl <br />end mnmtenance o� Ihe imp�ovement or olher nghPobway uan herefo <br />apphed foi and luriher agrees to removn sama upon notice Irom Ihe <br />Gty and lo replace pu�hc pro erty�gad �hereby. <br />Signat phcan De�e <br />WORK AUTHOR1IED B' THIS PERMIT MUST BE STARTED WITHIN <br />180 DAVS OF DAfE PERMIT IS ISSUED AND TNEREAFTER IS 70 <br />BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAV AE <br />CANCE�LED BV THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 L�4VS DURATION. <br />