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i <br /> ; <br /> � <br /> Date���:.��' ��„�����w�,.>��,,,..,�, . �fJ'—,�/ _ <br /> , <br /> Applir,abon For '�'�+�+ ��n� • —�i'�' 193�/ <br /> FUBL.IC WORKS PERM17' � ���°°w°„°�°° ----- <br /> ioiel Fen s-- <br /> y I.�� Rpo� ��eePei� s _— <br /> Print or Type Onl� �'=�"� ��n�" ��Q� — <br /> (, e o n v rr f3_ �C....—LJ��.,'�y 1 M 1�._LQ_Z-._�w�t/I E 9.�1/Q3 _. <br /> Owner MaiSng Ad�ress Cdy Zip Phone <br /> ��A�I�icant Mailing Ad�ress Cdy Z.ip Fhone <br /> Describe Propose�Work __(1Qt�.II�1P�Qt19e��n�.�Q- �!L'�y—_S!.(�./.�'L� <br /> � I <br /> - - - _ W <br /> Projec: Add�esslilknawn) ��1 — ��9 �A�l . .s� _ __ � <br /> Attech lom�4)copies ol plans for piu��o:eA work� Draw lo scale anA note the following as apu�iwble- � <br /> • Property Lines • Centerllne uf slreet � <br /> • Outline and dimonsinne of�II r.xi;tiny�nd • Indica�e Nort� <br /> proposed slrur.lures on Ihe lot • Show eny proposed yratlinc� dinnc�r; <br /> • Existing end proposed utili�ies • Show mensurnments � <br /> DO NOT WRITE BELOW TH.S LW8 O . <br /> PERMIT CONDITIONS <br /> 1. All call�for Inspection shall br. made 24 his. in advance - phone 259•88�5. � <br /> 2. All work Shfli�tie perlormoA m nccord�nce with this permit nnd current Cily n/ Evereh Desipn and Construr.tinn <br /> Standnrds and 3pecilicntions. <br /> 3. Cali Locullon Untlargrountl Service 48 hrs belorn, you dig. TOIL FREE NUMBER 1•800•424•5555. � <br /> 4. Curh, gutter, and sidewalk are new s unbroken, any damage to them shall O <br /> be repalred/replaced by the applicant. <br /> 5. nny driveway location changes must be appr.oved : the Public Works Dept. � � <br /> and inspected prior to construct.ion. � <br /> �! I <br /> 6. Use public drainage system prov:.dad for roof-top downspouts. � <br /> � <br /> a , <br /> ACKNO'NLf.DG[MENT OF CONDITIONS <br /> The under=_i9ned owner/apPh�ant he�eby agrees to hold and save hnrnr <br /> - � ------ less Ihe City ol Everett Iwm airy nnd all claims lor dameges, cosls. <br /> expenses, or cause�; ol Aclion that may erise becouse ol installation <br /> c `� ,,,,,`/y e�d maintenence ot Ihe improvement or other nght�ol�wey use nereto <br /> / `'y �G`"+ "� -�Q�"�� epplied Im and lurther agrees lo remave same upon notice !rom Ihe <br /> ApproveA lor Gonsl ction Oate City entl to replaCe pubfic property dxmeged Iheroby. <br /> �; ♦., ,� <br /> _�L`a �/ �r 7 l � � � ,�[� <br /> FINAL INSPECTION Gate ��"- � �� �— �� <br /> Approved as ConsUucted Si9naWre ol Applicanl Date <br /> �����r�l PU�LIC WOfiKP DFPARiMENT WORK AUTkIORIZED BV THIS PEFiMIT MUST BE STARTFD WITHIN <br /> � 3700 Cedxr S�ree' 180 DAYS OF DATE PFRMIT IS ISSUED AND THEREAFTER IS T(� <br /> Everell. WA 9F201 f3E DILIGENTLY PURSUED TO (:GMPLETION. THIS PERMIT M4V BF <br /> Phon�• 't59�L9i5 � (:�NC[LLCD C3V THECITV UPON ANY STOPPAGE J�WORK ON THIS <br /> � f'H(Llt I;T (�V�R �ln OqY4 [IURATION <br />