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i <br /> , <br /> � <br /> � <br /> �. <br /> Date�.3��83 �„���,�wo,�.�w,�„�.c t�) .7'-9� <br />� <br /> ApnLcn:ior For nin,� oeM • .—Soll�7�QU � ' <br /> PUBLIC WORK� PERMIT °��;�W�;�.�°°—�-- _— <br /> i�,ss�ro� re.ra�n S I <br /> G�_" <br /> Fru t oi Type Only o�����ao�� s <br /> CSPnnprflY �l� N -��� �� �r,t�{P_ ;�/G3 _S�l�- &a/3 <br /> Owner Mad�nyAad�ess Gq� Tip Phone <br /> Sn.H P - ---- — -- - <br /> Appficen� 4Aa�ling Address Oly Z�p Phone ' <br /> Descrilin Propose�l Work _�L'.1�;�_��.f.�l�lfi/�i�.Q.`_D'��_G1,1-j/1_L�L��1�t,(1 __ <br /> -- -- -- - --- � <br /> Projec�Address�if knownl ��4 �� ��7��h ��-- — � <br /> A'Inch loui(A)coples of plans lor proposeA work� Draw lo sr.�le nnd note Ihe lollnwing as�pplicalde � <br /> • Property Lines • Genle�hne ol ;trerl ,A <br /> • OW� �e and dimensions ol oll exisun{�anA • Indrt:ote NaiPi V� <br /> p�oposcd slnw�ures on ihe lal • Show Rny prq:os�d prndin�,� rhangrs <br /> • [risting nnd proposed ulilitins • Show mr.aau�emenis � <br /> UO NOT W�11iE �EIOJJ THIS L�ME <br /> PERMIT CONDITIONS O <br /> 1.All celis for inspetlion sha11 he made 24 hrs in.�dvnnce�pPone Y59•OBl O � <br /> 2.All work chell b�pertormetl'n ar.cordence wdh ihis pennil..nd cu�rent;;dy ol Everetl Design end Construction <br /> Slanda�os and Specilication,i. <br /> 3.:ell L ocalion Unde�grounA E�ervice 4B hrs.be�ore you diy.TOLL FREE NUMBEH 1•800•424•5555. � <br /> A. K•eep City street�i cican at all times. <br /> 5. Use rublic drainage syetem for roof-top down-spouts. � <br /> 6. Curb, gutter and sidewalk are new and unbroken. Any damage must be <br /> replaced/repaired by the ap�licant. <br /> 7. My changes to the driveway curb-cut must be ap��roved by the Public Worke � <br /> Inepector. <br /> O, il�i7l(Jf�6 Fx�STin.'v l�,�i�%SlvA� Cck'v'-GL•� .t'.c�o �('Si'C9r'6 !�/iTr/ � <br /> �!/CG /'6ioi%.r CU.e'b' ��l7 L>t-!T£.�' . TN1�iCC •t:r.J D,�'it'fcCN9y O <br /> �f.•P C/� SrA,�.�.OrO �1nJ � <br /> AChP�OWLEDGEMENT Oi COND�TIONS <br /> The undersiynetl ownauapplicanl hereby a�rees lo hold and save'i.n�n <br /> - ' less the City o� Everelt Irom any and all claims lor dai�apes co�:i•, <br /> /��? /� expensns, or cnuses ol nctlon th:�t may anse becxrse oi installal�nn <br /> �"J��C.� J7�rp/jz ,j�S .F _ nnd maintenance ol Ihe improvement or other nghbol-way use her��b, <br /> rppl� lor and lurlhr,r aprees to remove same upon nohce from Ih�• <br /> Approved lo�Consiru ion Dale ���y nd to repince puBhc property dPmagoA Ihere6y <br /> �1r c <br /> "�" '�i / " � �� � � <br /> �� A�-- ���„o � � '��� �! <«c�� � J 5J <br /> Approved as Cons�r�cted Si9nal e ol Apphcanl ,� Dale <br /> �,�����.�� PUBLICWORNSDEPARTM[Ni WORK AUTf10R17CD 8Y iHIS PERMIT MI�ST BE S''ARTEO WITHiN <br /> 1B0 DAVS OF DAiF PERMIT IS iSSUE� AND fHC�REAFIER IS TG <br /> � :f200CednrSlrea� BE DILIGENTLV PURSUED TO COMPL[LION TNid PERM'T MAV BF <br /> CvAre't.WA 9A201 (IANCf I I f D BV ilif CITV UPO�J ANV S70�f�'�C �d"WORK ON T1ii5 <br /> phpnr 259 HP10 1 N(l.l[ f:l i 7V( H <�n Ilp1'� f1URAT1(�Iv <br /> � <br />