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DeiQ� �� pu�bcWor4sPsrmll/ ✓ " —/ V <br /> Appllcelion For B�Gp.Depi • <br /> PUBLIC WORKS PERMIT PuEiaWorM�fea <br /> ,o�.�F.. � <br /> Lee��ppl.ise Pe�O � <br /> Pfl�lt Of TypB 011ly eei�nceova { a�� <br /> �1��7 U U l Z�l(1��. �? ��� n�Fy �T � fm m�n� �u1# 98Q57 s�3�0 <br /> Owner Mellmg Addreas Clt Zlp Phone <br /> --�p f <br /> p0�lcent Mailing Addreae Cfty Zlp Phone <br /> Deealbe Propoead Wo�k -�� <br /> Pro�ect Addreen(if known) ��� � r n�� Pc� .] i(pT�j/ p/' � <br /> M/l LY✓.� � <br /> Altach lour(4)coplee of plene for prop�.,nd wo�k- Orew lo ecele end note the lollowlnp ee eppllca6le: � <br /> • Property Linas • Centarllne ot elreel � <br /> • Outline erU dlmenelone ol ell eMletinp end • Indlcate North <br /> �ropoeed structurae on Ihe lot • Show eny prcpoeed gredl�g chenpes <br /> • E�leting end propoead ulllitlee • Show mee�urementa � <br /> �O NOT WRIT ELOW THI9 LINE O <br /> PERMIT CONDITION9 <br /> t. AI�cane lu��neoaction eheu be mede 24 h�a u�odvence• nhone 269•B81 S. � <br /> 2. All worM ehell ba perlo�mad In eecordence wlth tNe permlt and current Clty ol Eve�elt Deeign end Gonetruclion <br /> Slenderde and 9pacRicetlonn <br /> 3. Cell Locetlon Underpro•ind 5ervice 4B hra before you dig.TOIL FREE NUMBER 1•800•a24•5555. � <br /> f� cS/DCiuqLKS �A/� STpF,�S A.E'E Tc t�1E' 1�`EPT <br /> c."f EA.�/ �IT A[L Tim ES O <br /> � /�/�/ i�9m�d-E PONE To T//F Cv�B f�u�rE,e #' S�O£�✓9C,r � <br /> /9.e/D MN. C.*� B�9CY. � TNE pQi✓EaIAjI SNi1[L BE � <br /> iPESoo.�fiBi(Z7-y/ d{ TNF A�O�iCi9NT T .PEP�qcE. <br /> 6, �y << w.�C ,PE�sa�,c�- AADiT�O�t/9L Anf�,�adq� 0 <br /> {,eo M Ts�f ��Br�c woQ� �soT, a <br /> ACKNOWLEDQEMENT OF CONDI110NS <br /> The ur�dersignad owner/eppllcent hereby agreee lo hold end aeve herm- <br /> — leas the City of Everslt Irom eny end ell clelme lor demegae, cosls, <br /> ���y �7 expensas, or cauaee of acllon Ihet mey erise beceuse of Inatalletion <br /> /�G L�/ � G� end meinfenence ol the Improvement or other rlghPol-wey uae hereto <br /> �� � epplied lor nd IuAher agre a lo remove eeme upon noticn Irom the <br /> Approved lor Co uctlon Uafe Cit end t lece ubHc <br /> y p p perty damegad Ihareby. <br /> a1, '� 6 � � _ � } - °; , <br /> FINAL INSF ;TION Dete � + /�C � ! <br /> App�oved en_'onslructed ip ure ol Applicanl De�e <br /> everett PUBLIC WORKSDEPARTMENT RK AUTHORIZED BV THIS PERMIT MUST BE STAFTED WI7HIN <br /> � J200 Ceder Streal 180 DAVS OF OA7E PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everatt, WA BB201 BE DILIGENTLV PURSUED TO COMPLETION. iHIS PERMIT MAY BE <br /> Phone: 259-8815 CANCELLED BV TNE CITV UPON ANY STOPPAGE OF WORK ON THI,�i <br /> PROJECT OVER 90 DAVS DURATION <br />