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( �t/ • � � <br /> Date� ���. :,,,�.��.,.,.. �/ <br /> S'r.� 7 y' <br /> uinn onn� . __ �..1..Jf.���` �� " <br /> Appl�cetion Far <br /> pU6LiC WORKS PERMIT PubTol�Fae'�� s–�o °�— <br /> l�u�PDI F�e PsiO ` -- <br /> B�bnn Du� 8 <br /> Print or Type Only d s0/� <br /> ��F,��� <��e � 5��'`,�� �1 � (�� C �..�.- y�_ <br /> Owner iulelling Addiass Cily 21p Phone <br /> z <br /> \ o <br /> _� <br /> ��Rm e � <br /> APINicant Mnlling Addrxss ---- CItY ZiP Phona m <br /> Descrlba i�roP�eeA Work _� )�r -� ��f—/` -- --- ----- -�' <br /> .. -y <br /> _ in x <br /> --_'__ — .—._ � <br /> O <br /> -- C G <br /> -- � ___—_ � m� <br /> --1 C <br /> A� `'J._ � O <br /> ProldclAdGrneelilknownl L�'T �.---_ '�� /n� » /�L" :S�— -- -- yy <br /> �� m <br /> Attech focr!A1 copies ol plene Im D�opo .J worF Dinw to ecale end notb iha lollowing es epplicnhb .� <br /> � Centerlina ol street � Q z <br /> • ProParty Llnee � <br /> • Ou!Ilne end dimanelona o1 ail eaieong nnd • Indicete North r � <br /> proposad slructuree on Iha bt • Show xny pwposeJ gran.ny chm�9e��, ��. <br /> U Eeistlng ard propoved ut�'�Ities • Show mon5urements � <br /> � �i <br /> �� DO NOT WRI7E BF.IOW THIS UNE o ' <br /> O f <br /> -� r� <br /> PERMIT CONDiTIONS <br /> m �. <br /> t Ali calls�or�naver.uon r��nll be moda 24 C:a m ud+ence�Phone 259•8815 � 'r <br /> 0 <br /> 2. All worF ahall ha oerirnned in accordence wllh ihis permP �nC �•urent City �I Everon Cir•,u�n n�A�;��isl�url�.nn o r <br /> c� r <br /> Srpndnrde end Spncr: �alions. <br /> v <br /> :l Ce�l Lnr.etion Undery�-nnd Fervice 4B hrs betore yni �;iq TOLL FREE NUMBER 1•L100•424•5555. w�� m �� <br /> L z C. <br /> I � � �, <br /> r <br /> s <br /> �'. <br /> i � n <br /> � <br /> r/ - <br /> I` � � <br /> I a ;. <br />� <br /> /1CKNOWLF.DGEMENI OF CPNDI�IONS <br /> The undera�gned owne�/apD�lcanl hereby epraoe lo hold end snve hArm� <br /> ---- -- leee Iha City ol Everett Iram eny end ell cleime lor damegxe, costs. <br />� axpenses, or ceusea ol actlon Ihet mey erise becauea of Inelellntion <br />' _�-��e�a�5�. /�C���J'.� end meintenance ol tha I�mVrovemenl or olhrt� rinhl�ol-wey use hereen <br /> � � epp ed lo� and lurther a rees to romove eame ipon nohr.a Irom Inn <br /> Approved for ConBtr clion �� / oe'B Clty end �a replec3 publlr,prope�ty denaged Ihereby <br /> i 'I - n <br /> V � c, . 1 �/ � [�� �t,/ <br /> �a_�t �, J, 4-� : • �- ( 4'� r 1 \ {�n - �,..� —1=� 3_�! — <br /> FiNAL IN PECTION Dete �1��-'�^�-- -- <br />( App��oved BS Cona�ructed/ � Signeturn ol App�lcen� �'��� <br /> WORK AUTfiORIZED BV TH PL.FiMIT MUST BE STAR7ED V 'HIN <br /> p�r�Pn PUBLIC WOPKS DEPARTMENT 1B0 DAYS OF UATE PEFMIT IS ��SUED AND THEi7[AFTER IS TO <br /> � ?200 Cudnr SUxet BE DILIGENTLV PURSJFD �O COIAPIETION. THIS PERMIT MAv dE <br /> EvPretl WA 98201 � CANCEI l FD PV THF CI1V I�PO^! ANV S10G'PA(iF OF WOR�� nN i HIF, <br /> Phonq 959-R015 �'HiiJ[�(II i1A'f fi v�i IlAFS t1 IRdlu)N <br />