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Dete�1�� <br />Applicalion For <br />PUB�.IC WORKS PERMIT <br />Print or Type Only TO POSTING� 1��.� <br />/�/ i <br />�'uL��r WnMPnrmi / -r�� <br />�� ���� <br />n�,,o o.o� � .� <br />R�o�v Wo�nf�e = __ _ " __ <br />,�,a�..� -- -- <br />iee� enui re� Pn��i 6_ --. <br />n,i,�,,.t.��n il_� __ <br />Mailing <br />ai� <br />� ^���_�� g <br />Deacribe ProOosed Work __._...� <br />— - .,-,�1 ���-� �r �i= <br />Prolecl Addresa (11 known) � � v - <br />A�18Gh loUr 14) topies of plan8 �or propus5d wo�k � D'aw to ecalp �ntl nola Ihe Ic owmg as apPllcahle <br />I- ' <br />w <br />� <br />• Property Linea <br />• Ou1Gne and d�mensions ol nll e�isting end <br />proposed slructures on Ihe I� . <br />• E�isling end proposed ulllllias <br />•) Cenlerlme ol slreet <br />• Indicete North <br />• Show any �roposed grntliny chenyr.s <br />• Show measurements <br />Pn��e <br />PERMIT CONDITIONu <br />t. All calle for Inspacllon ehall be mede 24 hre. In edvence • uhone 259•881 O. <br />2. All work ehe'I be pedo�med in ecwrdence wilh thle permit and currenl Clty ol Eve�ett Dealgn and Con6t�vction <br />Stenderdb and Speclllcellone. <br />3. Cell lceetlon Undarpround Servlce 48 hre. befine you dig. TOLL FNEE NUMBER 1•800•424-5585. <br />� G[.,��A N � <br />q� 5�zc�EZ <br />r�lsriNr, t�-< <br />�N l7�i✓ <br />c�✓c� �.,TJlNJi-�/R- <br />L ,�ry o� ��-xE7'T STJ7. -t6G�`� <br />pyp�p�( PUBLIC WOFKS DEPARTMENT <br />� 3200 Cedar Slreet <br />Everet�. WA 98201 <br />Phona�.259�B81C <br />ACKNOWLEOC[MEPIT OF CONDITIONS <br />W <br />I'�' <br />� <br />� <br />� <br />O <br />� <br />� <br />� <br />a <br />Tl�e unaersipned ownei/npplicnnl hereby ag�aes lo hold enA seve ha�m� <br />less the Gly ot Everell Irom eny and all clelms lor damegea. cosls. <br />e•penses. or ceusr.s ol nction ihal may ense hecause ol installation <br />nnd mainlenencn ol 'he :mprovement or olher nghbobwey use herelo <br />epnlin• (or anA �urlher ngrees to remove aeme upon notice Irom tne <br />Gily and to/�lace pubhc Oro�rty demnged theieby <br />WORK AUTNORIZCV BY TNI3 PERMIT MUST BE STARTED WITHIN <br />IEO DAVS OF DATE PE MIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSU.� TO COMPLETION. THIS PERMIT MAV BE <br />CANCELLED BV THE CITV UPON ANY EiTOPPAGE OF WOP'( ON THIS <br />PROJECT OVER 90 DAYS DURAiION <br />