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i <br /> �; <br /> Date�_3� ���,�,�� �,.,,�,�,.,���,o.b r�'-%,�� <br /> 4PPlicollon For �u,��� u.m . _G7_a��� �3^_ <br /> PUBLIC WAfiKS PERMIT �",�°,°°,�.�°° <br /> .o�.�.�. s— <br /> �...�on� r..rn,a S <br /> n,i.� �..o,� S ��� <br /> Piini or 1'ype Only — <br /> �.ne�r r„ 1nc �Ri y -�/.���a�- �.z�d I e.�[�_-5`i.Z S� � 3 <br /> Owner IAedingAAtlres� C�ry 7�p Pn� m� <br /> SIYMF.. _ . — . __—__ ._ <br /> Applicant Meilint�Adtlress Cdy Zip Phone <br /> Describx Proposed Work �QrAI .$�y�� ��� B �bf l� Z(,V��_��L(,i _ <br /> Prolec� Address lil known) U--�- —� �d� � P�• S-E- ---- — � <br /> � <br /> Attach lour 14)co0�ag ol plans for proPosed woik� Draw lo scale and note Ihe lollowing as applicanlr � <br /> • ProOer�y Lines • Cenlerline ol strert � <br /> • Outline and dimnns�ons ol �II e�isting ana • Indir,ale North <br /> proposed st�uctures on Ihe lot • Show�ny p�oaoscA 9inAmg <3ringes <br /> • Ezisting and prol�sed utililies • Show measwemenls � <br /> 0 �i WFII"E BELOW TIiIS LINE � <br /> PERMIT CUNDITIONS <br /> 1.All cells lor inspection shall be made 24 hra.In xdvance�phone 259•88�0. � <br /> 2.All wo�k shnll be perlormed in eccordence with this permit and current City ol Everett Desiyn anA�onslruction <br /> Stenderds r-.nd Specificalions <br /> 3.Call Localiun Underground Service AB hrs.bebre you dig.TOLL FREE NUMBEH 1•800•424•5555. � <br /> � . nriv ci ini���: �iv ri iE �r,rvewr�v rur ri��.-,i r r �;r r �;�. � � <br /> C�1' THF FIlULIC Wf1Rl 3 01 F'ARTMf PtT O li <br /> .`i.UaE FUFLIC DFiA1!VAI�G SVSTEM A5 F'RO'.���?F f? f �7� "i i�J �' . � , : I <br /> 6.A�11' Lt�T [iRFapE GiANGI=S MUST BE 111"�F'R�]�'f ���. r.�� I"�'�= <br /> FIII�'u. f�' binl;:l �� TN,�,i.('TfIR � <br /> ?. 6I f t: � I I � ll,-I:1. 1 ,- �•I i� Ai,� � � I � �� I � �iq� ' � I <br /> O <br /> � <br /> ACKNOWIEUG[MENT OF CONDITIONS <br /> 1 he undeisionEd owncuapplicant heir.by egrees to hold and save ha�m� <br />� - less the Clly cl Everett Irnm am� anA all r,laims lor Aa.rTges, cosls ' <br /> �/ ezpenses, or r.auses ol aclion Ihal may arlse because ol installalion <br /> Ci�.(Q�� ' �/O"d� T 2 /(/�l �nd main�enance nl Ihe improvemenl or olhpr nghbol�way use he�eto i <br /> �nn��ed to� end lurlher �qrees �o remove same upon nohce Irom �he <br /> Fpp�vQA��r�nslrucLon� / . �/ ' Cale CpY�nA to rePlare puUlir proPerty dAmayeA Ihareby <br /> , ,;,� ,_ : , �� � /// /I f/ <br /> �.�,%4�-=/' �-- / �{'����� U ~�� � �'l/f�� ,rvTQ.- - G �. �j' <br /> F A . INSPECiION• Date — <br /> Apr�o�ed as Const�ucted Signalure ol Applir.ant Dafe <br /> ' WOAK AUTHORIZF.D BV 7H15 PER�d1T MUST E SIARTED WI'NIN <br /> r•vrrrtt PUBLICWORhSDEPARTMENI 180 DAYS OF DA7f PFRMIT 13 15SULD AND THFREAFiEf7 IS TC , <br /> � 3200CederSlrert 8'c DILIGENTLV PURSUE� TO COMPLFTION. THIS PERMIT MAV B[ I <br /> Evere�l.WA 98201 CANCELLED BY THE CITY U°ON ANV sTOPPAGE OF WORH ON THIS <br /> Phone 259�9At0 PROJECi OVER 90 DAVS DURnIIOPI <br /> I, <br /> I . __ .. _ _ _ _. _.__ _— _. . <br />