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Date.�� �� <br />Applicntion For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />: is ir <br />Owner <br />l!! i� �=/� <br />APPlicnnt <br />- �. �,�� �� v7 i.e�ii , <br />Meiling Address <br />Address <br />�un�.c Y n.w� Permu ��?/ � _ <br />eiaa neoi • b'�f • �'!o o (J ___. <br />PiEIKWorMef�a '. . .. .---- <br />TMtl fa� <br />1 e�� �pD� Fae P�iC � <br />B�b�c� Dw i 2�� D�% <br />7ay7y <br />a'r ;7 '11',7n</ �., T - yU i�- <br />Cdy Zip Phonr <br />DnsciibePro0o5edWork _/NSIAIL -�S � �l�l<)a' ��'�='t l��;C� %�1}<'.•%�l:�H-y __ _ _.. <br />Pro�ecl Address (il knuwnl <br />«�� (5����i'� � <br />Attecb tour i4) copies ol plens lor proposed work � Draw lo ecFl�o anA no�e Ihe lullowmy 25 apphcabl� <br />• Property Lines • Conlzrline ol streel <br />•(�utline end tlimensions ol all existing and • Indicnte Norlh <br />proposed siructures on ihe lot • Show any propo:eC yratl�nq U,an,aes <br />• Ezisling end proposed �dilities • 51 ow measurr,mi•�Js <br />E <br />PERMIT CONDI110NS <br />1 All cell5 tor inspeCUon shnll be made 24 hrs. in advance � pl��one 259•881 5 <br />2. All work ehall be paibrmed in accordance wdh this permit nn� ; urront City ql Ev���rn Dcs�r,r, ;�r,tl Construcl�or, <br />Slenderds and Specilications. <br />3. Call Localion Underground Service 4P hrs belore you dig T�1LL FREE NUMBER 1•800•�i-4•5555. <br />ApprOv�1'o(C slruction ' <br />/ \ (� <br />� 17C.1 id��.�:t-.,,NL.. <br />fINALINSPECTION ��� <br />Approved as Constructed <br />rveietl �'UPI�CWORKSDEP <br />�� 3?UO �edar S�reet <br />En.� �tt. WA 9P201 <br />..� one 259-BB'.`i <br />_ j ,� , .,�5- <br />De <br />N1 <br />� <br />� <br />� <br />� <br />0 <br />�w <br />_/ <br />� <br />a <br />nC�"NOWLCDGIM[I:T OFCONUITIONS <br />����� unqru�qned owneqapphcanl hereby agree510 hold und 5ava herm� <br />n�ss ir,c Cdy ol Eve�etl Irom any and all claims lor demages, cosls. <br />e.nenses, or causes ol action that may anse because ci mstallxhon <br />antl meintenentz ol Iho imp�ovemenl nr othe righl-ol�way use +�rieto <br />apPhed lor ana luriher aprees to iomove same upon not�ce Irom Ihc <br />Cdy an replace puhlic properry damaped thorebv <br />, <br />`„ ' - - /�_ , � . f. <br />sign re ol APp�ic t - ate .. <br />W K AUTHORIZED BV iH15 PERMIT MUST BE STARTED WITHIN <br />0 DAVS OF DATE PEFMIT IS ISSUED AND TNEHEAFTER IS TO <br />B[ OILIGENTLY PUHSUED TO COMI'l fu(�r� nu�: �'Pf�t.nT �.1nV Hf <br />CANCELLED PV T�IF GTY UPON ANV� `��� �P�'n�;1 �t1 lyr)I;h r�N IIII.'� <br />�'NC1.ILl;7 ll�'C R�,U (IAVti pUHAI 1�7�i <br />