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i <br /> ; <br /> � <br /> � <br /> � <br /> Date � S Y p O / <br /> �1-/a r����er wnn.rnrmn. �pCJ ' �7G __ <br /> A�pliCetwn For Flinu u.ni . _�J.f[��____ <br /> i'UBLIC WORKS PERMIT °°�°r�;���,��° 5- -- _ <br /> i�•sn nnni i wr na•� S <br /> Print or Typ,> Only ""',"`"0"" s ��- _ <br /> CPmnl�rd ��ii�l N '" a- .3CGl •San���i�i3 .5.��_ �zi3 <br /> Ownei Mading AAdress Gty 2ip Phone <br /> SAmE _ <br /> Applicanl Maihng AAd•rss Ci�y Zip Phone <br /> Descrlbe Proposed Work �L.pyl_�/ N��N_�,. � �y �r C,+L L D 1 ,] //w/�,.� CPe�� . <br /> ✓ <br /> — yo� -� io >� --- — W <br /> P�Necl Addresslil known) �=�Ls�E _ � <br /> A�IAoh loui �A� cof�i^5 0l plen5 lor propo5ed work� Draw lo scTle and ncte Ihe lollowing xs apphcable � <br /> • Properiy Lines • C�nte�l�ne ol street � <br /> • Oullinn and dimensions ol all e.istmg and • Intlicalc North <br /> proposed S�ructures on�he lot • Show nny prcposetl��radm�7 changes <br /> • Exisling Hnd propo^ed utilities i Show mr.asuremeMs � <br /> DG NOT WRITE BELOW TIIIS LWE � <br /> PERMIT CONDITIONS <br /> 1.All calls lor Inspection ehall bu made 24 hra.in edvnnce�phone 2S9•88�0. � <br /> 2.Atl work shell be pedormed in accortlence wilh this pe�mit end currenl City ol Everett Desiyn and Construction <br /> Stendaids end Specllicetions. <br /> 3.Cell Loce�wn Underground Servlce 4E hrs.before you dig.TOLL FREE NUMBER �•$00•424•55b5. � <br /> 'i . : i �': i i '�.e��:i._ 'il f� �f. I.`I"T�,�L"Wli i:l' I . . ' !� ' , . i � , j <br /> i:1' - I � �'11L:� I . �1��.11�:1 �I:I '�"� � I U� �.'�1 . � ,. <br /> . LI�C IUL;L1� I �F�iPdla��i :� r5'fC�1 A'3 ff�U % I ���f � � � � � :�!i i . , <br /> 6 AN1' I OT GRA�C CHA�IOF4 MliST [+F PfFf+ri"I � I '� � <br /> ��I II�:I rr Ld,y:-.l �S 1 �.�c;�-f-f�T(�F. � I <br /> .. � ffl � 111' - '[! II ' � illi'JI ' . � I � ! ��p . <br /> � I <br /> I <br /> � <br /> � i <br /> a � <br /> ACKNO'NIEI�C;FME NT q� CUNDITIONS <br /> ln��undersipneA ownevapplicanl hnieby a9rer,s to hold and save ha�m� <br /> ' � - - - - --��� i��tis the Cny ol [vr.relt Ir�m nny and all claims �or Aa�nages, cosls. <br /> - /i , �Knenses. or causes ol artioo that mTy arise hetause ol inslallTtion <br /> t=�Y�„ ! d_�r� i/�"' gb and mamlenanr.e ol �he improvemenl or othe� ngh��obwey use herelo <br /> ' L��E� .��'t 7 npphed Inr And lurlhrr n(Jrees !o remove snme upon notice Irom the <br /> Approve lor Conslru on ate <br /> � � � Cil ai�A to ieplar,e public prnperPr AamegeA Riereby <br /> � Q�_ .�� /%�' `� " 1 /l(' _� ( y <br /> FINAL INSPE��� Date -�-�7 � /l�l Gii..-1� �' 1. Q <br /> Appro�raA as Constructr.d Siynature ol Apphcant �T Dela <br /> rv�rrlt °UBIICWORKSDEPARTMENT WORP. AUTHORIZ[D BY TNIS PERKiii MUST B� STAPiED WITHIN <br /> � 3200Cedar5lreet 1P� DAYF OF UATF PFFMIT i5 ISS�ED AND 1HEREAFTER IS i0 <br /> Everell.WA98201 BL DILIG[NTLV PURSUEC� TO COMPLETION THIS PERMiT MAV Bf <br /> Phone.259�B910 CANCELLED BY THE GITY�PON ANY STOPPAGE OF WOFK ON THIS <br /> PROJFCT OVf-_H 90 DAVS DUR�T'ON <br />� � <br />