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Date�15r92 <br />Appllcatlon For <br />PUBLIC WORKS <br />Print or Type Only <br />Bill Guetaveon <br />F", �'OSTING o�c i o �se <br />PERMIT <br />r�eiK wen. w,�,n . 3'L 9�. � <br />ewo onn�.. 39006 <br />WbNe Y'o�4 FN <br />Toltl FN / <br />La� �ppl M P�W / <br />l�OnN Du� � 2�- <br />PO Box.2702 ,Lynnwood WA 98036 788-6920 <br />INnQACtlr�et �. , ' � alry � , ' [iP ,� „ . � rnone <br />. . . , , . . i. . , ., , <br />Owner <br />Applicant MeI11n0 Addreae City Zip Phone <br />Describe Propoaed Work neY duple7c <br />Pro�ect Adaress (Ii known) <br />Allech lour (4) coples ol plena lor propoaed work • Draw la ecele and nota Ihe lollowinp ae appliceble: <br />• Property Lines • Cenlerline ol etreet <br />• Outline and dimenelona ol ell e�lsting end • Indicate North <br />propoaed atrucluree on the lot • Show eny propoeeC preding chenpae <br />• ExlatlnB and propoeed utlllllee • Show meaeurements <br />PERMIT CONDITIONS <br />1. All celle for Inepecfion ehell be made 24 hra. in edvence • phone 269-8810. <br />2. All work ehall be peAormed In eccordance with thin permit and cunent Clty of Everett Deslpn and Conatructlon <br />Standerde end 3pecllicetlons. <br />3. Cell Locetlon Underpround Servlce 48 hre. belore you dip. TOLL FREE NUMlER 1•800-424b5b6. <br />T /�l.a�.tt/n-CCN /�sf�n0�� �ff"Oh�l dJ�i�-iXl � � "-" � <br />!% J k� <br />�,,�(/��..,,..�,y �p�O,t2�.tCaJ !rL � �i��T -01�- Lt/R�f . <br />CiLLii✓N (� O'1" �Q�.�. �7�i �!'to7 �C.. �O�Y4.I�./ C07ti0[K-Z <br />t.�.if:G ,o��z .�- -�� �'^'-� �""'e`"-�'. <br />t,r�- <br />�GGi 1�7i*nls�- ______-��.3 <br />l�7 <br />Approved lor Construclion �7�Dale <br />' „�,j 1�,� �� - 9a <br />, <br />FINAL INSPECTI N � Dele <br />Approved es Construcfed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar 3treet <br />Everett, WA BB201 <br />Phone: 26B•BB10 <br />W <br />� <br />� <br />ACKNOWLEDOEMENT OF CONDITIONS <br />The underalgned ownar/eppllcant hereby aqraes lo hold and save narm� <br />lesa Ihe City ol Everett Irom any and ell clelmn lor tlemeges, costa. <br />e�penses, or cauaee ol ectlon thal may erlee beceuee ol Instellallon <br />end meintenance of thr. improvemenl or other �fpht•ol-wey use he�elo <br />epplied lor end lurlher egraes to remove same upon n..�lce Irom the <br />Citv and to �eplace public properjy �ay�ped fhe�eby. <br />�IVORK AUTHORIZED BV THIS PERMIT MUBT BE STARTED WITHIN <br />1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIOENTLY PURSUED TO COMPLETION. THI9 PERMIT MAV BE <br />CANCELLED BV TME CITV UPON ANY BTOPPAOE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATiON. <br />