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S <br />��I � �'���G,I �* <br />Application Fo� <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />• �/ //. / <br />.� i d i• <br />Manmq ANJ�ess <br />M]�0� � <br />� Oescribe Proposed Wn�k <br />' Pro�ecl Addrees Iil knownl . %%� ��� s���([!le � <br />up <br />PupNe Nbrl�� PMinN • .3 e <br />e� o.w . <br />VuDIK Wp11it �N <br />ra.�rN • <br />leu �001 ie� MM ! <br />Baync.o�• ! /� <br />Alfach low 14) copie6 of plans lor proposed wark � DrnN� ro scaln ,�nn note tha fo�lowing as apuhcab�r.. <br />• P�operly Lines � Cnnled�ne ol streat <br />• Outline and dimenniona ol all exls8nq antl � Indicale North <br />prapoaed slructures on Ihe lot • S�ow Bny proposeA pratlinq c�anpr.s <br />ropoeed utllitlea • Show measurements <br />PERMIT CONDITIONS <br />1. All ulle lor inepectlon nhall be mede 24 hro. In edvance • phone 259�8810. <br />2. All wo�k ahell be pedormed In accordance wtth thls pe�m11 end curtent City ol Evere@ Desipn and Conatructlon <br />Stenderds end Specillcetlone. <br />3. Cell Locatlon Undeiground 9ervice 4B hrs. before you dly. TOLL FREE NUMBER 1•800�424•5555. <br />4, ��r� fo .i� �r�e �per �o�+, � 4�Prov� � <br />oh 8-z -y s, (�y„y Q.f 4�vko'� <br />. <br />� <br />Dalx <br />es Construclod <br />PUBIIC WORK3 DEPARTMENi <br />3200 Cedar S�reel <br />Evere14 WA 98201 <br />Phone:258�8810 <br />'392 <br />W <br />� <br />� <br />Z; <br />�� <br />� <br />� <br />0 <br />a <br />ACKNOWL:DGEMENT OF CONDITIONS <br />The untlersiA�ed owner/apphcant hereby aprees lo hold and seve �arm• <br />iess the C�ly o� Everetl Irom eny and all ctsim6 lor Camaped corts <br />e■pensoa or causes ol action Ual may arlae beceuse ol fntttllation <br />and mamtenance ol Ihtl �mprovemBnt Or olher nphPobway u!e herBto <br />ann��Pc ior and lur�ne� egrees lo remove same apon nol�ce Irom Ihe <br />C�!y ana to reptace pubhc o�operiy tlemeQed t�ereby. <br />Signalure ol ApOhtant Dtle <br />WORK AUTHORIZED BV TMIS PERMIT MUST BE STARTED WITMIN <br />1B0 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br />CANCELI cD BY TNE CITY i1PON ANY STOPPAGE OF WORK ON THIS <br />PRO.�ECI OVER BO DAVS DURATION. <br />