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� <br /> Date���5/94 '� � I PUCbcWorMPermn• �S �Q __ <br /> AppliCation For �_ Tr• POSTI NG � � / e1ao oeo� . 46�— <br /> PUBLIC WORKS�ERMIT P�bT�1eien�ee a — <br /> a <br /> n lee�sooi iee aa�e S <br /> f� S 7 in� <br /> PNnt or Type Only M � � � r esis.�e o�� _�ii <br /> r rd , ., ���' � E�� '— <br /> I1 <br /> p �1ro ou �torJ <br /> f��j o� �O rl yd r.l r.• <br /> Ill M N x� b1 M rJ <br /> Goldmark Ent�rprisea 915 Stitch Rd �Lk Stecens '" 98258 334-9656 <br /> Ownar MailingAtld s, .b (,� �q1y Zip Phone <br /> N C, N Ll � (� `i W <br /> _K1Ys � � a i i r�}, �i � <br /> App�icant Meiling Address City Zip Phone <br /> Describe Proposed Work _ N m du <br /> — ����L!-�[11a..r(!,�_ <br /> P�oiectAddresslilknownl I�i2q - 111th PI 5�1/___ �+B ���' ~' � <br /> Altach lour 1�)copies o�plans lor propnsed work- Draw to scale and note ihe lollowing as epplica6le: � <br /> • Property Lines • Centerhne o�st�eet � <br /> • Outline and dimensions ol ell e�isting and • Intlicate Norih <br /> prOposed slructures on Ihe lot • Show any proposed giatling chenges <br /> • Exisling end pro�osed utllilies • Show measuremenis � <br /> DO NOT WRITE BELOW TI.IS LINE <br /> PEHMIT CONDITIONS O <br /> 1.All cells lor Inepecllon ehell be made 24 hre.in edvance•phone 259•8810. � <br /> 2.All r.ork shall be pedamed In eccor,ir.nce wilh this prrmit end current City of Everett Design end Constructlon <br /> Slenderds and Specificatlonv. <br /> 3.Cell Locetlon Underground Servine 4B h�s.belore you dig.TOLL FREE NUMBEH 1-800•424•5555. � <br /> �. r.e�eo c iW s�reeis c ieun ut aii mnet. <br /> r�q�)r�V11Bf CI'1C�5�(�E`YlO�I In Il�o�,.P�� r�rp�n...� rin-� �inrp7m!7��nr�. Clfly�:7'i1C7��F II�Ur•�0 SIIO�I Vf'�P�ICrnrJ 4� IhF O <br /> �iecielion ul Il�e Pu�lic Wcilo li��u��:.loi. <br /> .. nrn channe In the drlvpwrn eul musl be approvpa by Ihe PW Irxpeclor,widlh at prop Ilne Ilmltetl to exkllna � <br /> apron wlUlh. <br /> , Na�iKl wrner boxes to qrade at era ot corutruchon. <br /> � Sul tenc cK anc1.'O.•OIhPf P.!(XIOi1 COf11f01 li1POSIJfEK Shflll hP If1S�0Up(1 I)Y IhP hUIIAPf C71 �hP CUfPC11G�p!ihP Pi�hV� � <br /> NGIt 5 ItKpFC IG�. <br /> . Hooltop tlralnarye•,hall Ue tlKchrrgetl: � <br /> 'oh. � �; � r � y v C�onnecl io Ihe plaPs r,lonn draln syslem,a stub h provltled al the Ironl ef Ihe Io1. <br /> �..�.�h.� t. ;. C�i�nec I �o Ihe lof,incllvid��ul Irench diaui pra�lded al Ihe reur of euch IoL � <br /> � o��hon: C are nn s i br lat c�n not �o dan.ipl Ihe urea ol Ihe Iren[h droini <br /> ACKNOWLEDGCMENT OF CO�JDI?IONS <br /> _ The undersigned owner/applicant hereby eqrpes to hold and sxee hnrm� <br /> I less Ihe Gty ol Eve�etl I�om eny antl all claims lor tlamnges. costs. <br /> / � expenses. cr causes ol acGon that mny arise brtcause ol instolletion <br /> ____�� � ���_'. and r.ia�ntenance of Ihe improvemenl or other righFol�wey use hereto <br /> applied for end Iurther ag�ees to remove semo upon notice I�om the <br /> Appro oA lo� sVuction Uatn <br /> City and �o replace oublic prope�ty damaged �hereby. <br /> �4�—_ L2, �` t Q�tn�-���,-3�� <br /> FINAL INS . CTICN Oatc <br /> Appio�,ed as Consvucled Signature ol Applicanl T Dato <br /> � PUPLi"WORKSDEPARTMENT WORK AUTHORIZED BV if11S PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStrea� 180 DA1'S OF DAiE PERMIT 15 ISSUED AND THEREAFTEH IS TO <br /> Everett,WA 98201 BE DILIGENTLV PURSUED TO COIdPLET10N. THIS PERMIT MAV BE <br /> Phone:258-BB10 CANCELLED�Y iHE GITV UPON ANY STOPPAGE OF WORK ON iH15 <br /> PFOJECT OVER 90 DAVS DURATION, <br />