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� �ow���Fo� oe�a �1��q <br /> PUBLIC WORKS PERMIT /� � <br /> PubBc Works ''ertnit u v'� z� <br /> PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar street G��_� <br /> Everett, WA 98201 (425)257-8810 Buqding Permit M <br /> TYPE OR PRINT ONLY T� pOSTING � � 9 � Public Works Fee S � <br /> U.�-� plu i IdP/YS C22,1� 5�CVUCf.� n1�l I �✓� -�IP�'� 98?,Gg �'7�i-3S3- 7405 <br /> Ownar Mqlllnp Addross Clly IIP Phone <br /> Applicant Malling�1Mlress Gy ZiD Plwne <br /> Descritw Proposed Work _ ��'J(J_�j _ 1 � 1 <br /> W <br /> -- � <br /> ��/� <br /> — — V♦ <br /> PPWECT�\CDRESS (if known) _S� f lo(� PI SE �,�q ��dr�v� I�a�p�,l' � <br /> Attech lour(1)copiea plena lor proposeA work• Ji�H�o ecalo end nolo the Idlowing II epplkable: � <br /> •Properry Unee •Outline end dimenalone ot r,ll ealstinp erM proposed etiuctures on Ihe bl •Exlating and proposed unlitlea ' <br /> � •Centar!Ino ol slreet •InOieale Noith �Show eny proposad gredinp r.hangae •Show measuremente <br /> DO NOT WRITE BELOW THIS LINE Z <br /> PEFIMIT CONDITIONS: O <br /> 1. A!I calls for inspecticn shell be mede 24 hours in advance- phone (425) 257•8810 <br /> 2. All work shall be perfarmed in accordence wiih this permit and current City ot Everett Design and ■ <br /> Construction Standards and Sped(icatlons. � <br /> 3. Call Locatlon Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800-424•5555. �/� <br /> I F"r.,� rih• .nr�-I. ���..an at ,�II fimrc v� <br /> ; i wb euuri ;aid ,id�walti m ihr pl;+l ;ur nrw aud un,I;wr.�Eted. ;my d�mage Iherolo .I��II bt IC(II71C[II Al (IIC O <br /> r�r,rrctlnn nf�tlic (qi��lic N'nrks Incprctor � <br /> �� ,1uy ehunKr m Ihe dm•ew�n' cut musl be �ppiot�td b} Ihe ('W Insprclnr. �ndih nl piop liur finoleJ li� rzulin., <br /> nptnn widlh <br /> ,1dju.l wntei hoxr, lo �rade al end o(con:lnicl�on. <br /> � �hiv�'wrn^' chall hc complcicl�� rured hcfnre dii�7nr, nn Ihem <br /> '� I�uc tu Ihc prescnce ol'HrtlrmclN sd thr foF1i' OI�IIIIH SI�P. lllfPct rcoflop diYun<<qc rmJ mettJl a <br /> I�i�p��r•i�,n trrnc6 hnill .0 per �cctiou i-2 6.2 ,md i�igmc i->.? n��d Table i-2..i of thc ci�t� <br /> `>�oiuiwFuer R1mia¢ement Msmuul (copy sinpled to Ihie penuiti. Diepersion syslctna J�ouid he <br /> b�ickliU��d In Ihr su�i:ic�• ��ilh �rs�vel to allo���for ov��r(low i'r.11 Publi�• Workat'ar.u� inv���•clinu <br /> I,�i:'� ��� <•cce�iue h'�•nches "ILe di?persion evvtem Nhall hr locnled alonq Ilir ndee o}'the u�rllfuid <br /> hi�il �i niil� ;i rimmiuni Intt � >tb�ck tiom huildinc foundation. <br /> ACKNOWLED(3EMENT OF CONDITlONS <br /> �/ The undeislpned owner/eppllranl hereby aprees W hold end er.ve Aermleae <br /> '"� � � Ihe Clry ol Fveretl Irom eny and ell dalme for damepes,oosh+,expenaea,or <br /> ove or ons nx wn e e cnusea ol ectlon tliel mey eAee Gecauae ol Inetellatlon and m:�Mtanence ol tlie <br /> -7t/ ^ e knprovemenl o�other rlphtal-way use herelo epplMri bi aM!urther apreee lo <br /> !� ./� . /d'�S°l;f�� 7-7—GO re e upm ratke Irom Ifre Gty entl M replace publk PropeM dem� <br /> peO ttiere y. <br /> FINAL INSPECTION Dele <br /> Approvetl ea Conetructed O��� <br /> ipne re o can � e <br /> V0.7Fil(AUTliOR�A BV 7}AS PERAMf Ml.'ST BE STAHfED WITHIN 1BO�DAYS OF 1iATE PEiiAfi I$ISSI�D MA THEFEAF'TER IS 70 BE URICEMLV PUASUEU TO <br /> OOAAPlET101d.TMS PERMff M4Y BE CANC�LLEO BY TFE CRV UF'ON ANV S70PPo�(3E OF 1M7i�f ON THS PRJ�ECTOVER BO WV9 WRATION. <br />