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I <br /> Datc�c5,._`.�:J ^wleww e«Ne• 3 /�� <br /> Py V6t aLm roe aip pest <br /> PUBLIC 'WORKS PERMIT ^wTOWF" . <br /> INN an { <br /> Leu AAarlNME{ <br /> eswe Due <br /> Print or Type Only <br /> J ��1sYl.,cs 799v -n'>e't R•ylL: 2,,. Lveeµ 9'E+Zo"'1 3�5- Cge,4 <br /> Owner Mailing Address Cny Zip Phone <br /> SCJ m� <br /> Applicant Melling Address city Z,D Phone <br /> Describe Proposed Work sz.IuaR., u�-_ of LQRPid r/L lku� w•�h H•�IJJ k�Ln�. <br /> W <br /> Project Address Id knowm 7`132. 4r_c r 2D. _ __ leasse <br /> Attach lour UI copies of plana[or proposed work!•Draw to scale and note the following as Applicable. <br /> •Properly Linea •Centerline of street / <br /> •Oupine and dimensions of all existing knd •indicate North v, <br /> proposed structures on the lot •Show any proposed grading changes <br /> {Existing and proposed utilities •Show measurements M <br /> DO NOT WRITE BELOW THIS LINE WO <br /> PERMIT CONDITIONS <br /> 1.All cans for Inspection shall be made 24 his in advance•phone 259.8810. <br /> 2.All work shall be performed in accordance with this permit and current City of Fveretl Design and Const rust Ion <br /> Standards and Siaecdicationa <br /> O.Cell Location Underground Service 48 him before you dig TOLL FR E E N U M BE R I-500-4'.14.5555. Z <br /> �. !1`�Qaauo,>- aoT.hbl �Fiyact- /2E2 ,cc�� ,f�l..•�a!/� O <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm. <br /> len the City at Everett tram any end All claims lot dsmage: costa <br /> ��' andet,enset or causes of improvement <br /> that t or arise because of Instuse h1ation <br /> rsto <br /> and maintenance Of the implOVAn10Ol Or other right-Of Use hOrelo <br /> ^ applied for and further agr Io remora-me upon notice from the <br /> Appr d for na u n Cny end to triple blic pr edY damaged iherriby. <br /> _ 0"- -s, <br /> FINAL INSPECTION Dales <br /> Approved as COnstiuVed Sign tune of Applicant Oalb <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200 Cede,Slroet tag DAYS TL DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett.WA 08201 BE DILIGENTLY THE CITY TOCOMPLETION.THISGEO PERMIT MAY IS <br /> Phone 25 BRIO CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORN ON THIS <br /> PROJECT OVER 90 DAYS DURATION <br />