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oece 5-25-93 �,,,kW,�.�,�,„. q� 2ze <br /> Application For eao.o.o�.. 40718 <br /> PUBLIC WORKS PERMIT P+�IkWorluFn <br /> T�.�F» s <br /> �«.�F..�.a s <br /> Pri�t or Type Only <br /> a.�.M.o�. s 3S� <br /> Robert J Brown 7423 20th St SE Everett 98205 334-793} <br /> Owner MaiFnp AdOresa City 2ip Phone <br /> Ovner <br /> Applkant Meiling Address City Zip Phone <br /> De�cribe Propceed Work Parking spaces, replace sidevalk, move dumpster enalosure <br /> - W <br /> Pro�ect Address(H known) 2917 Paciflc Ave � <br /> Attech lour(Q coFias ot plane for propwed work-Draw to scale and note the tollovdnp as applicable: " � <br /> • Propsrty Lines • Centerline of street � <br /> • Outlins�nd Olmeneion�01 ell exittinp end • Indlcate North <br /> propoted�tructuros on the lot . • Sbow any proposed grading charpes <br /> • Exlttinp�nd propwe4 utifitba • ShoM me�surements � <br /> DO NOT WRITE BELOW TMI3 LINE O <br /> PERMIT CANDITIONS <br /> 1.All dNs fw inspectlon sh�tl be mede 24 hrs.In advsnce•phone 259-8810. � <br /> 2 All vrork�h�ll be perfortned M�ccordence with this permit and current Ciry of Evarett Design end Condruqion <br /> 3hnAad��nd SpecMiqtbna <br /> 3.Call La�ation Underyround Ssrvice 48 hrt before you dip.TOLL FIIEE NUMtE111$00�4243655. � <br /> O <br /> � <br /> � <br /> O <br /> a <br /> ' ACKNOWLEDGEMENT OF CONDITIONS <br /> The undereigned owner/applicant hereby agrees to hold and save harm- <br /> less the City of Everett trom eny and all claimn for damages, costs, <br /> �7���fl�i�J� �h G/�.3 ezpenees, or eauses ot ection thet maY eriee beeeuee of Installation <br /> end maintenance of ihe improvement or other rlght-ol-way use hereto <br /> �"` epplied for and lurther agrees to remove same upon notice from the <br /> Apprwed lor Conetruction Date City and to replace pubiic property demaged thereby. <br /> FINAL INSPECTION Data <br /> Approved as Consiructed Signature of Applicanl Date <br /> � PUBLIC WORK3 DEPARTMENT W0f7K AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CederStraet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 9B20t BE DILIGENTLY PURSUED TO COMPLETIOK.THIS PERMIT MAY BE <br /> Phone:25B�8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DUf7ATION. <br />