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Dete 4-Z1-93 <br />Applicatlon For <br />PUBLIC WORKS P�'RIIMIT <br />Print or Type Only <br />Hill Guetaveon <br />PO Box 2702 <br />WA 98036 <br />PvDuc Wonu hrmn • <br />eaa o.m . <br />PUQNt Worlu FN <br />TOIII FN / <br />Lo� �ppt fw PtlC / <br />Nl�nu Dun <br />� Z�m� <br />007 - dZlslO/ 783 / <br />788-6920 <br />Owner � <br />Applicenl Mellinp Addreea Clly 21p Phone <br />Deacribe P�opoeed Work lli.tigetion and Revegetetion along Silver Lake Czeek. <br />P�olac� Addrenn (il known) <br />Attech lour;4) copiee ol Glans lor proposed work � Draw to scale and note the loltowlnp ee eppliceble: <br />• Property Llnes <br />• Outline end dimenelone ol ell exiatinp end <br />propoeed atructu�ea on the lot <br />� ExlatinB end p�oposed utllitlee <br />• Cenlerline ol alreel <br />• Indicele NoAh <br />• Show any p�opoaed predinp c�enpee <br />• Show meaeurements <br />PERMIT CONDITIONB <br />1. All calle for Inspectbn ehall be made 24 hro. In sdvance • phone Z6a8810. <br />2. All work ehall be perlormed In ecco� tence with thie permit and current Clly ol Everett Deelpn end Conetructlon <br />Standerds end Speclllcatlona. <br />3. Cell Locatlon Und+roround Service 48 hro. belore you dip. TOLL FlIEE NUMSE111 •800�424Bb5b. <br />5`, �!/Oi k�n be dor.c �r �Dl.fa �1�vtorFa G�v ffic <br />c:�j- Pla��; �� 4��/ ��61;� �dc��r dc,of o., y.ss �� <br />��,�oy 4lfw����./ <br />A roved 6 onstL io J ale <br />i:. l. � ��Q,�jll �OC�i //- 9d <br />FINAL INSPECTION Dete <br />Approved es Conalructed <br />�PUBLIC WORKS DEPARTMENT <br />3200 Ceder Slreet <br />EveratL WA 98201 <br />Phone: 269•8810 <br />ACKNOWLED�EMHNT OF CONDITIONS <br />W <br />H <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undereipned owner/eppllcant hereby aprees lo hold and aeve herm- <br />lese Ihe Clty ol Ev ett I�om any and ell clelms lor damapea, coete, <br />eMpei�sea or ceu e ol ectlon thsl may erlee beceuee of Instelletlon <br />end mainlenan ol tha improvement or other riqhhol•wey uee hereto <br />epplied lor a lurther ep�eee to remove same upon notice Irom Ihe <br />City antl to plac�public property damaped thereby. <br />� SS. <br />Slpn lurs' AppIICaN � ' Oale <br />WO THORI2ED BY THI9 PERMIT MU3T BE STARTED WITHIN <br />1B0 DAYS OF DATE PERMIT IS ISSUEO AND THEREAfTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED 8Y THE CITY UPON ANY STOPPAOE OF WORK ON TH19 <br />PROJECT OVER 80 DAVS DURATION. <br />