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i <br /> ' <br /> i � <br /> � <br /> , <br /> � <br /> Date_�-� l) � ��� .. .,�,, �, ���"l�� <br /> C I C'fI � '1 <br /> APPIiCa�iOn For n.e., U..�,� . —�(�_ —�_{.`��'r�. <br /> PUB�IC WaRKS PERM �T ^�°°�W°��°��° <br /> ,���a��.� s— -- <br /> ��•++anni �x.rx�n S� _ <br /> Print or Type Unly o.,�„�«o�� s __ <br /> L c�,c�cr,o ��� i�� � . � � ci� ��c>� �ra-n�� �slv 3 5ca �-ga�3 <br /> Owner Mading Address Gry Zip P..one <br /> � App can� Maihng AAdress Gly Zip Phone <br /> Oescribe Proposed Work _����,���L�T_,�I ���C�/-�� � . <br /> .�.1�� <br /> 7'f <br /> Prolecl Ardress lil knownl y� 7 — /O9 tA pL• S�r ----.— — � . <br /> — � <br /> At16�h lour(�) coples o� plans lor proposed work- Draw lo sr,nlc nnA nute Ihe follnwing as apphr.abic � <br /> • ProperlY Lmes • Centerhne ul sirect � <br /> • Outline and dimensions ol all c�istinq and • Indicatc Nor16 � <br /> propo6ed StrUr.lures on Ihe lol • Show any propos�+d yrlUmq chanqes <br /> • EziS�mg ond piopoSeA uhh�ies • Show measuremenl5 � <br /> DO NOT WHITE B�. _OW THIS I.INE <br /> PERMIT CONDI710NS O <br /> 1.All calls lo�inspeclion shall be made 2A hre.in ao;flnce-phone 2S9•BB�O � <br /> 2.All wo�k shall be perlorrced in accordence wilh Ihis �ermil and�urrent GI y ol E�rreU Design�nd Construclion <br /> Slandards end Specilicrtlons. <br /> 3.Cell Locetion Underg�ound Service 48 hrs.be�ore you dig,TOLL FREE NUMBER 1•800•424•5555. � �� <br /> 4. Keep City streets clean at all times. ' <br /> 5. Use Pu�lic dra+�age system for roof-top down-srouta. O <br /> G. Curb, autter and sidewalk ace new and untroken. Any damage must be <br /> replaced/repaired by the applicant. <br /> 7. Any chanqes to the driveway curb-cut mu�t be �.��provcil by tl�.e Public Wock, � <br /> Inspector. <br /> 8, S.6C1'in�✓ v� GLv���vHf� GIJi.6-Ca•T q/O> >r� f,'E (�lF. n i.r 7�� /ldinndlD � <br /> �jNO .f�6/�G9cE0 C-UiTi,��fUl[ {/E�G.✓7 C(u'rY 9w/U l�c.�TTc:c: . N�i�J D.iiaCic�e'f/ � <br /> �p � INS7ALCE0 f'E•c' Ci7�/ S�r+�vOq,F'!.� '�.�01 <br /> a <br /> ACKNOWLEOGEMENT OF CONDITIONS <br /> The undersipneA ownec�pp6cnn�herehy s�rees lo holA and seve ha�m- <br /> - --�— — less Ihe City o� Everett Irom iny anA alt claims lor damages, r.osts <br /> expenses. nr cause5 0l action that may ense becausr, ol �nstallation <br /> <-����d'a / �/.�/,�8 and mnmt^nanr,e ol ihe imGrovemenl or other n�hd�ol�waY use hereto <br /> f�L applled Ior and Iwlher xp�ee5 lo remove seme upon nolicr Irom IhF� <br /> Approved lo� Ccnstluclion Dale Cdy anA lo rrplar.e puLlic proper�Y Aamaqed Ihrreby <br /> � % '' <br /> i <br /> � ` � .� �i � �� � �e S � <br /> .��.L�� �LC-- <br /> PINAL INSpECTI / ^ Da'e ��_.— —..__ — <br /> AnP�oved as Constructed ` S�ynature ol Applicnnl Date <br /> ��ve�roll PUBUC WOFKS OEPARTMEN7 WORK AUTHORIZED BV THiS PERMII� 61UST BE STARTED WITHIN <br /> �� 3200CedarSlreel lU0 DAVS qF DATF PEFMIT IS ISSUED AND THEREAFTER IS l0 <br /> Evmett.WA 99201 BE DILIG[NTLV PUHSUFD TO COMPLETION THIS PEHMIT MAY E7[ <br /> Phanc. ?59�RBi� CANCELLED BV THE GITV UPON ANV SiOPPAGE OF WORK ON THIS <br /> PROJECT OVEF7 90 DAVS DURATION <br /> I <br />