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� <br />, <br />oeta s�� t ��4. � � � � <br />Appllcallon For <br />PUBLIC WORKS PERMlY <br />� Print or Type Only <br />C v�Y <br />Deecrlbe Proposod Work <br />Pro�ect Addrees (If known� <br />.Si4.., � <br />c� <br />_ ��PUM�c Wo•he Parmit • L <br />OiepOeD�-• _. <br />Pubnc 0'orA� Fee �l� �— <br />To1�IFee a `� V <br />Lnu AoO� Fee P�iC S���T��_ <br />Bel�nceDua S�V ___ <br />o- /3��x /� 9� F�y.Jl l.J.� 45 <br />�ddress Clty Zip <br />�S ,-a 6..K <br />\ddress City Zip <br />�/�� /1��. G' �'4� <br />s� C � /��? � <br />w A — T _ _ � V !/ � � <br />Attech lour (4) copiea ot plena lor proposed work • Draw tu ecale end note the lollowing ae epplicable: <br />• Property Llnes • Cer.larlinr of atreet <br />� Outline and dlmensiona ol ell eziating and � Indicate North <br />propoeed etructuree on ihe lot • Show any proposed greding chenpes <br />• Exletinp qnd propoaed ulilitles • Show meseurementa <br />PERMIT CONDITIONS <br />3GL <br />1. All cells Icr Inapection shall be made 24 hre. In edvence • phone 259•881 b. <br />2. All work shell be perlormed In eccorAance wlth thle permit end current Clly ol Everett Deslgn and Conalruction <br />Stendarde end Spec111catione. <br />3. Call Locatlon :Jndergraund Service 4B hre. belore you dip. TOLL FREE NUMBER 1•800•424•5555. <br />� f'!,'�6�CC�9lJi GJ/GG �c�.¢�'n�i%/Z �rli// <br />. cv.r.5� F��r�i5��` G�j'-�� c��%����=y�r. - <br />�' ,�'��.-�!'�v.,� c,��Ti�'oG �viG-� cz5"�' %�if�li.t%�-j <br />�S ¢�/�E',E'cZ'T�V_ <br />Date <br />FINAL INSPECTION � \ �/ <br />Approvad es Conshudle� Q <br />everetl PUBLIC WORKS DEPARTMENT <br />� 320U Cedar Slieet <br />Everetl, WA 98201 <br />Phone::59-Ptl15 <br />ltCKNOWLEDGL"MENT OF CONDITIUNS <br />W <br />H <br />� <br />� <br />O <br />� <br />� <br />� <br />a <br />The unde•signed owner/applicant heraby agraes to hold and sevo harm• <br />less the (:ity of Everait Irem eny end all clafms lor damapea cost:; <br />expenses, or ceusas ol ;�ction that mey arlse because ol Inetallation <br />end maintengnce ol Iho ��nprovomant or othar right�ol�wey use hereto <br />applled Iqr�nd further eg�eos to remove same upon notice Irom the <br />Gty anc� replace public proporty demaged the�eby. <br />5lI;)h�fure ol Applicant / " �ete <br />AJORK .4UTHORIZED BV THIS PERM�T MUST BF 5TARTEO WITfiIN <br />18U DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPI.ETION. THIS PERMIT MAY BE <br />C:ANCELLED BY THE CITV UPON ANY STOPPAGE OF N'ORK ON THIS <br />F'ROJECT OVER 90 DAYS DURATION. <br />