oate_i�-vl: �J �
<br />nt�Phr.�h„�, I �.,
<br />PURLIC WURKS PER�VIITi
<br />Print or Type On'y
<br />q�plicxnl
<br />[.s
<br />c:�iy
<br />, � ,.�,.,,..c�"` ��'^i�-�/��
<br />,�.�.ui o�,m . � �/ � � c�! �p�
<br />,� �,,„w.,,., �.�
<br />lnlql �YI� !
<br />I�•..� A1:1�� 1 er� I�n�il i__ .
<br />��. �� ,, .. n„ S _ _oz�'�— . _
<br />�l�t�-�ra`Ji��'��,
<br />7�c Pnone
<br />--- - -
<br />Ma�hngAAd�ess Ci�y J�f�
<br />D�•srnbe Pruposetl WorM �.�L�_. _�_lS�. . ��- � . - _. _.
<br />Pro�ecl Address Id knownl — ��_L� _1.-� ST SL__ __
<br />Atlaeh' �ur 141 �opies o� p�ens lo� p�oposr.d worF � Ura�n� tr� srale� .ind mHc Ihr inllovn �y a5 apphr;d�ir
<br />• Propnrty LineS � GF�Inll�flP OI slre•nl
<br />• Oulhne end dimenswn5 0l all r.isbnq ;inrf • Intl�ra�p North
<br />propocetl S�ruc�ure5 nn Ihe InI • Sh�u� a�Y Propus��C grnd�nq r.l�ani)��s
<br />• E�isling xntl Uiopo9Ed u�dihrs • fihuw m��a;urernnnls
<br />'�7�-1-.��
<br />__��,�;;P ---
<br />PF.RMIT CONDITIONS
<br />1. All calls Irn insGection shell be mode 24 hrs. in edvance � plione Zb9•8810
<br />7. All work •.hall be pedormed in na. �rdan..e with !his GPrmil and currenl Cdy ol Fverett ?esign und l,onstiuct��o�•
<br />SinnAnrAs anA Sper.i�icn6ons.
<br />3. Call Localiun Undergrounr' Servir,p 4P :vs 1:'�lo�r: ycu diq TOLI FREE NUMBEN i•SOO•4'lO•SrJS�J.
<br />[� .�"�,� .(./ . _. _..
<br />,�o�- �? y/�_�9
<br />APP�'oveA I Grnstru . �on 7 [1F1'�
<br />� � y�-�-�^—
<br />i / '
<br />FINALINSPECTIUN ����' 'e
<br />ADProved as �nnslrur.leA
<br />��vrivtl PUBLIC WORKS DEPARTIAENT
<br />� 3200 L'eda� Slreel
<br />Evrrpl�, Wq 98201
<br />Phone 259�PR10
<br />, . � � ��.,, �,,,,� �,� ���,��,�,�,�.,,, ,
<br />W
<br />�
<br />�
<br />�
<br />�
<br />�w
<br />_ /
<br />O
<br />a
<br />��� und��n�yn��J „¢ �v.i. nUC .,fnl h���rl�y uqrPes lo huld:fn�l eavB ndfm-
<br />�'Sti II�B l.iiy UI EVH�dII �' lm afly LOA 011 Cl2�rt15 �C� (Iln1T9tl5. f,0515.
<br />r�,penses. oi r,auses - .bon Ihal may erlse b•cause o� installa�ion
<br />2nd maln�PnAnrp r ipin�omenl ur olher npht�obwxy use herelo
<br />epphed lor and ' ,rees lo remove same upon nolir,e Irom Ihr.
<br />C�tY �^� b reul:y r�p�ly ABfj7A(JP.A �hElP.by
<br />Siq��nlu/t' o� A��PIicd/ll �� Ddle _ .
<br />WCRK AUTHORIZED Y THIS PERMIT MUS7 BE STARTED WITHIN
<br />180 UAVS OF DATF ERMIT IS ISSUED AND THEPEAFTER IS TO
<br />BF DiI,IGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE
<br />G4NCF:IFD BV THE GTV UPON C.NY S70PPACE OF WORK ON TNIS
<br />f'1'�)Jf (�T f1V1� Il �1/1 �pVS f111�411��N
<br />
|