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DateS�_�'S �� � ' <br />, r Applicalion For <br />PfJB,'�.IC WORKS <br />�S <br />ri <br />�� <br />Print or Type Only �} %� `� <br />:; o u <br />c�ici <br />«, ..� <br />N/�a�in w�� i aiRF C��al� <br />owner <br />� <br />Applicnnl <br />ID I;L�Isil`�� I�� <br />PERMJ� JUN 2 6 i��� <br />v�� �s No <br />Mnilinc� AAdress <br />CI i 1' 0� EVE('�T I <br />L'Ic:,(. Pem�it Cou�i1� r <br />%% •;; <br />-wn��sn.,m�i. - _� _ <br />UePI • <br />,._.._�.._., s <br />— Total Pee - <br />l�sf AODI !en Pma S <br />oainnca0�r S '��- <br />-�s7"St. s.w. EUa2�rr, wA <br />c�iv z�n [ <br />E <br />Zlp Phone <br />�3��9 <br />"537L <br />Drscribe Proposed Work _j�STL�LI {�-IV �►_G� T �� � U C�� �• <br />�,.�a ►.�� �c�� Q c.�oslS 6S�k� A R D Fs N?n A N crU Fo R <br />U� dAI t� �. e.0� n .�, �. � n� E72 . O W IJ�/Z { S LI V1 N C AT TH�. s r� <br />Pio�etl Address lil knownl <br />AI!.-u:h tour �4) copies o� plans lor proposed work � D�aw h scale �nd note Ihe lollowin� as applicable�. <br />• ProperlY Lmes • Centerline ol streel <br />• Outline 2nd dimensions ol all ex�shng anA • Indicate Norih <br />proposed structures on the lot • Show any p�oposed gradinq changrs <br />• Existinq and proposod uti6ties • Show measuremenls <br />NO7 WRITE BELOW iH15 LINE <br />PERMIT CONDITIONS <br />1. All calls for inspeclion shall be mede 24 hrs. in advance - p�one 259-881 O. <br />2. All work shall be peAormed in accordance wilh ihis permit and current Cily ol EvnrMt Design end Construclion <br />Slandards and Specilications. <br />3. Call Location Under9round Service 4B hrs. beforo you dig. TOLL FREE NUMBER 1•800•424•5555. <br />� J2<il l�c� r� r1=•,���� i�'f ••tEl�`I.IG ��%'/.Jtt�n .('!(1 G� ([-�n���(/ (� . <br />./�7! �/'�/ � <br />/'C'7it�J�J.CO:�/ � �CI�C�r.J /�(��at.[� -Ct/CC-N C//ItCfCl�'�:,� �_r�.. <br />(/ � , <br />,'I"-_ � ; ( r. , l ' . <br />� �, � � � <br />_ '�i � //-+' —%: = 7— i — �� <br />Approved foi Consir�c on Date <br />../Ct�/�-(�1�� -% � 3 �� �� <br />FINAL INSPECTION �A�e <br />Aporovc� as Construcled <br />�j='7� PUBIIC WORKS DEPAqTMENT <br />'���i � 3200 Cedm Stmet <br />t�� Fverel�, WA 98201 <br />�no�� zs��nnio <br />�CKIJOWLL176Ch1LNi O� CUNUIlIONS <br />W <br />H <br />_ / <br />� <br />O <br />� <br />V/ <br />O <br />a <br />Th�� undr�isiqn��d nwnei/appLainl hembY:i9rrtes Io hotd and save hn�nr <br />i��r,s u,o Cdy nl Everett Irom any anA all claims �or damoges, costs <br />erpenses ur causes ol nction that may anse because ol installTtion <br />and maintenance ol ihe in,provement or olher nghFof�way use hercln <br />npphed fo� and lurlher agrees to remove same upnn nolice irom Ihr <br />City and to ieplace pu6hc properly AamageA Ihere6y. <br />� �� z � �� <br />Sie nature ol Applic nt ��e e� ( <br />WORK AUiNORIZED DY THIS PER � MUST BE STARTED WI7HIN <br />1B0 DAVS OF DATE PERMIi IS ISS [D AND THEREAFTER IS �O <br />BE DILIGENTLY PURSU[D TO GOMPLETION. THIS PERMIT MAY f3C <br />CANCf LLED BV THE CIiY UPON ANV STOPPAGE OF WORK ON 7��!ti <br />rr�o.i! cr ovrr+ s�o onvs ouraarioN <br />