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r <br /> i <br /> go/3 sGS <br /> Date_- Pio 0.0 /_2 <br /> .0 P..mn. - <br /> aMfp Oe01s�y��-_ <br /> H PUBLIC WORKS PERMIT °°"IKr°I.I FF", �8 <br /> ee <br /> 1.3 top 11101 Fee Pa,d S <br /> A x TO POSTING._ /d-2 aa�ance pue S 20! <br /> >r3'CA <br /> Print or Type Only <br /> K o �, Q c y i r11l 2 y.F/—o1 � <br /> 1-30 <br /> O .'>:O Owner Melling Address ny Zip Phone <br /> '9 M e-0 <br /> N <br /> z L9-Lc•-x� — <br /> Applicant Madmg Address Cut ZIP Ph^ae <br /> J r00, g <br /> ^ @1 Describe Proposed Work -- <br /> �� n <br /> g rA H 114 — r, EC sE ---- W <br /> Project Addrr.aril known) ���si 1 <br /> y N Attach four 141 copies of plans Ior proposed work-Draw to scala and note the following as applicable. <br /> O W • Property Lines • Centerline of street �^ <br /> • Outline and dimensions of all r casting and • Indicate North v <br /> proposed structures on the lot • Show any proposers glading changes <br /> • Existing and proposed utilities • Show measurements wA <br /> 00 NOT WRITE BELOW THIS LINE WO <br /> PERMIT CONDITIONS <br /> 1.All calls for Inspection shall be made 24 hisin advance-phone 259.8810. <br /> fw w 2.All work shall be pedormcd In accordance with this permit and current City of Everett DE sign and Construetlon <br /> 1 0 311 Standards and Specifications. <br /> 3.Call Location Underground Service 48 firs Woreyou dig.TOLL FREE NUMBER 1.800.424.5555. <br /> N <br /> 4.ANY CHANGE IN THE DRIVEWAY CUT MUST BE APPROVED O <br /> tw BY THE PUBLIC WORKS INSPECTOR. <br /> 5.CONNECT DOWNSPOUTS TO PUBLIC DRAINAGE SYSTEM. <br /> +�..:.. B.KEEP CITY STREETS CLHAN AT ALL TIMES. <br /> 7.ANY DAMAGE TO THE CURB AND SIDEWALK WILL BE REPAIRED <br /> TO THE SATISFACTION OF THR PUBLIC WORKS DEPT. AO <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> w'w <br /> . 11b The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the City of Everett from any and all claims for damages. COSI. <br /> expenses. or causes of action that may arise because of installation <br /> and maintenance of the Improvement or other right-of-way use hereto <br /> _ applied tot and Iwther agrees to remove same upon notice from the <br /> Approved for Const n Date City and to replace public properly damaged thereby. <br /> FINAL INSP CTION Datc <br /> r <br /> Approved as ConstructedSign Iwe of Applicant Date <br /> �— <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> everelt PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Ceder Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everett WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> W <br /> Phone:259.8810 PROJECT OVER 90 DAYS DURATION. <br />