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�/ <br />Date� � <br />Applicalion Frn <br />PI�BLIC WORKS PERMi f <br />Print or Type Only <br />Realty, Inc. 1429 Broadway <br />Puni¢ WmMe Permil • � �' / / <br />��ul DnOi • <br />PubbcWorh�Fee f <br />Tolel fee <br />I.nee �n0� fen Pa�C s <br />Hm.ncn I)ee f �L7 �� <br />Evere[t 98201 252-1166 <br />GIY Lp ..pr,—�or � <br />J 6 D Buildere 1429 BroadwAy Evere[t 98201 252-1166 <br />Apphcent Mniling Address Ciry Zip Phone <br />Descdbe Proposed WorF_ N0W Single Familv Reeidence <br />, Z 2C% - " r' <br />Prolect Addieae ,il known) 9/ —/�l ,S F <br />Allech fow �4� copies ol plens lor p•oposed work - Drew to scale and no�e the lollowinp as �pplfcn6le. <br />• Property Lines <br />• Outline end dimeneions oi all eaisting nnd <br />pioUosed siructures on ihe lol <br />• Gisting 9nd proposed utilities <br />PERMIf CONCITIONS <br />• Centerllne ol 9hpet <br />• Innicele Nor�h <br />• Show any proposed 7rediny changes <br />• Show measurements <br />1. All cnlls tor inspeclian shnll be mede 24 hrs. in advnnce � phone 259•88� $. <br />2. All work shHll be performed in eccoMence wlth this parmil end current City of [ve�ett Desiyn �nd Construclion <br />Standsrtls end Specificetions. <br />3. Call Locallon UntlergrounU Service 9B hrs. belore you dig. TOLL'qEE NUMBER 7•8JG 424•5555. <br />T LE�('�STi.c'�i CL%['B !'!.'i FF= IJL'iD��otJ�� IviL�JT /.r'E <br />7,� Ei� OU� f,�il/t� ���L9CEl� !?/rTj� F.t[ /YFiI•Ni � <br />�'t�i_'/3 #" Ga�/Tl,�. i'Eti f. � si�id�al.�l� �.jns d 30b <br />`S-- �,s�k��e.T ,vEn: d,�',�E,✓t�y ,��,c <br />� �iC> 7. <br />Apprevetltor <br />Z� :.0 I <br />FINAL INSPECTION � <br />hpproved 86 Con9lrur.te <br />rvrirll PU��LIG WORKS DFPARTMENT <br />� 320C Cedsr Slreet <br />Evereft, WA 9!+201 <br />_� Phm � 259-flB15 <br />Date <br />r.� srs��f�r�� <br />ACKNOWLEDGEMF.'JT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />O <br />♦i^ <br />Vi <br />� <br />a <br />The undersignetl owner/epplicqrd ha�ebV egrees lo hold anA save ha�m- <br />less ihe City of Everett Irom any and ell claims for tlamapes, costs, <br />eepenses. or causns ol eciion Iha1 may erise beceuse ol installalion <br />and �aeintenance ol ihe improvement or olher riphf-obwey use hareto <br />epplied lor nnd Iw!her ngrees W remove same upon notice hom Ihe <br />Gity nnd lo replxce public prope�W demeged thereby. <br />j " ' <br />.�`,�.1�.� �� 1�.� .s � �-� <br />Signeture o� Apphcent % a�p <br />WORK AUTHORI2ED BV THIS PERMIT MUST BE iTAI�TED WIIHIN <br />180 DAVS OF DATE PERMIT IS ISSUED AND T� �R�A�TER IS TO <br />BE DILIGENTLV PURSUED TO CC"dPIFTION. Th:S PEC•.Ili MAV BE <br />CANCFILf-U F3v THF CITY UPQN .'NV STOPPAGE �l� V�;:RK ON THIS <br />I'lIJ,1FC1 UVFR 90 DAVS DURA�i�JN <br />