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�`� PuO��e Work�Pnm�l• <br /> �H�@ <br /> BIEp.DW�.• <br /> Applicatioe For <br /> PUBLIC WORKS PERMIT "'°""'°".F" <br /> To�.�F„ s <br /> 1.,.�oo�Fee F.ia f <br /> g�l�np Dua = <br /> Prfnt or Type Only plan Chtck Not H 49817 SEPA <br /> ]�pplleat.Dat�s 10/19�95 <br /> Job Addrss 1602 H WITT AVE <br /> Own�rs SROTDAL ART <br /> T�nante US WEST <br /> �--- Propo��d U��: STORACS Z;p Pnone <br /> Ownar D��c. of Nork� <br /> BQUIPYAND NSTIILL�ANTBNNASKONGROOF�L FOR <br /> � Applfcant OFFIC6 SST JOB SBT Zip Phone <br /> APYRVD FOA PERMITs DATE_/_I_ BY <br /> DeacHbs Propoaed Wo <br /> W <br /> � �Ikf Addross(il knownl � � � � .� <br /> � ,: .l• <br /> � Att�ch four(4)eopies of Plans tor proposed work• Oraw to swle antl note the I011owinq as applicable: � . . <br /> • Propsrty Linsa • Centerline of atreel . -`��`;`�' <br /> � � �ndicate NoAh . '':•{ <br /> , • Outliee md dimenaions of dl existinQ and � Show any proposed prading c�enges � � ��`L <br /> ' propoaad structures on the lot � Show measuremeMs M '. <br /> i • Ezistlnp�nd propoaed utllitias W �`� <br /> � DO NOT WfiITE BELOW THIS LINE O �riA� <br /> i .y <br /> PERMIT CONDITIONS � <br /> � 1.IUI c�lls for Inepection ahall De m�de 24 hrs.In�dvance-Phone 259�881 O. <br /> 2.�p„qrk eM��ye psAamed in eecordance with thia permit end curront Clry of Everott Deeiqn and Conatruction . <br /> i St�ndard���d Specifitatione. � <br /> 3,Call Lautbn Underyround Servke 48 hro.bef�• e you dlp.TOLL FREE NUMBER 1-800�4245555. <br /> If O <br /> I <br /> 1 �UiLtC WOR1t• �Bl1NIT � <br /> NOT REDUlIIGB � <br /> !Y� <br /> SATE � Z 9r O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold end save�arm• <br /> Iless IY.e Clty of Everett irom any and all cleims for Camagea costs. <br /> expenses, or causes ot action that may erise because of installatlon <br /> and maintenance of lhe improvement or other righFof•wey use herele <br /> applir,d lor and lurlher agrees to remove same upon notice irom ihe <br /> Approved lor Conatruction Dale � City and to replace public property damaged thereby. <br /> i <br /> FINAL INSPECTION ' Date Date <br /> qpproved aa Constructod Signature of Applicent <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarStreat BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everott,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON 7HIS <br /> phone:259�8810 . PROJECT OVER 90 DAYS DURATION. <br />