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i <br /> DBIeJC) ta7 r„mK wog..o.imppn. 97- 377 <br /> Application Far aide b.m•_�L,14 <br /> n- <br /> PUBLIC WORKS PERMIT <br /> �•..APPi F..P.M ! <br /> Print or Type Only <br /> n oa. . ! 2T_. <br /> \i.nG4T1 a 1��l I A►F ( � CiT �i a.0 ,r i?ps 39co <br /> OwneQ Malling Address Clly Zip Phone <br /> Applicant Mailing Address 1 City Zip Phone <br /> Describe Proposed Work L.v(A — P 12O2 <br /> Project Address Id knnwnl <br /> Attach four(4)Copies of plana for proposed-work•Drew to scale and note the following as applicable: <br /> •Properly Lines <br /> •Outline and dimensions of all existing and 0 Centerline of street <br /> 0 Indicate North <br /> Proposed rtruclures on the lot •Show any proposed grading changes <br /> •Existing a r-proposed ufill9e, O Show measurements <br /> I �sw M <br /> DO NOT WRITE BELOW THIS LINE rM <br /> PERMIT CONDITIONS O <br /> ' <br /> I. All calls for Inspection shall hts made 24 his in advance•phone 289.8815. <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 firsbefore you dig TOLL FREE NUMBER 1.800.424.5555. <br /> Z <br /> p <br /> r <br /> ! a <br /> O ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm• <br /> Ives the City <br /> of Everett from any and all claims for damages coals, <br /> expenses or causes of action that may arise because of Inatellallon <br /> end maintenance of the Improvement or other rlghFoLway use hotel, <br /> Approved for Con ru on 44Date applied for and further agrees to remove Same upon notice from the <br /> City and to replace public p ty damaged thereby. <br /> FINAL INSPECTION Date •32•SE3 <br /> Approved 89 Constructed LgOptics Date <br /> DePUBLIC WORKS DEPARTMENT WORK A RI2 D BY THIS P IT MUST BE STARTED WITHIN <br /> 3200 Cedar Street 180 DAIVF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett WA 98201 BE Dill TI Y PURSUED TO COMPLETION,THIS PERMIT MAY BE <br /> Phone:2698815 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />