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ynro <br /> � t_ 1 � , ,,. .: ...�..: . , y� <br /> � � y D�tv� '�i-� � /l��`{-� <br /> 10 W Enn�� omn . _��(� YU�---�-! <br /> ,C, � = APPlir,ilion For .___ � _ � -,. <br /> F� --- -- <br /> � � PUBL.IC WORKS i'EI�MiT ''"°'""'°„'``° <br /> ,�„�«� S--- <br /> y i�.ssnnri �'<�.�'e��� 5_ '__ —. . <br /> O t90 <br /> �C M � L.Ya� r O,i.. S_— I <br /> N H -- ___ <br /> � � � Print or Type Only <br /> ° � � ' �-►�ri�C� k����'.c�L �' C� 1._ _ �', r�', � <br /> N , c � Maihng Atltlrass Ci�r �ip Phone <br /> ,,, y � �)�rnei . <br /> t <br /> M H __ <br /> N <br /> M Maihn Address City Zip Phonc <br /> p O N ApPlicant 9 <br /> 7 �y � ,i _—_.' <br /> •j p y DCS.:nUc Froposctl Work <br /> ��.�—��_ �1 c�]��� ( ����Z, s�--— <br /> / l - n - � <br /> ProieclAtldresslifknown) "�-�L�L-:� -� ��}0 l�fllC M ��� _ � <br /> Attach low 141 cepies o�Plans for proPosed l��ork- Drav� In sr.ale anC nol�:Ihe ing a�aGU��cab�e �� <br /> • Pwperty Lines • Centedine N �Ireet (/^ <br /> • Oulhne ^.nd dimensions N al1 existing and • Intlicate No�Ih V� <br /> pro�osed struclures on Ihe lot • Show any proposed yiudin9 changes <br /> • E.islm9 ano p�o{.osetl ulihhes • Show measurements M <br /> W <br /> /.� DO �OT WFITF B[LOV.'THIS L WE � <br /> I �� <br /> _ PEfiMIT CONDITIONS <br /> 1.All calis lor inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> � 2.All work sha!I be pedormed in accordance wi�h Ihis permit and current Ciry o�Evarett Desiqn and Construction <br /> I Standa�ds ard Specitications. <br /> �� 3.Call Localion Underground Service AB hrs.before you di9.TOLL FREE NUMBER"I•800•424-5555. � <br /> ��� <br /> f�( 1��� � /1 � t- ! -;� �. . ; �/ Q <br /> �.i : ,�r �" i � . <br /> ' � � �'�i ' H <br /> , ��� � i� "' � . '�.'/'- <br /> � �(� ' . ,� i <br /> ' r O <br /> ��� <br /> _ --- <br /> a <br /> !._ <br /> i r1CKNOWLEDGeN[NT OF CONDITIONS <br /> ' , d The undersi9ned oe:neVaut licant heroby ag�ces to hold and save hmm� <br /> I 1' �, Iess ihe Gty ol Eve�ell �rom ;any anA all d:Jms tor tlama9es. cosls. <br /> \ expenses. or causes ol ac.�ion that may anse Uecause ot instaliation <br /> � <br /> antl maiNenanee oi Ihe imprOvemen� or olher righl�ohway use he�e o <br /> appGed �or and lurihei aqrees to remove same upon notice Irom ihe <br /> Approved br Consiruclion ��'�� C�ly anA�o�eplace pubhc property dnma9ed IhereUy. <br /> FINAL �:NSF'ECTION ����' � <br /> Appreved as Consiruc!ed Signalure ol ApplicaN ������ <br /> WORK AUTHORIZeD BY THIS PEfiM1T h1UST BE START[D WITHIN <br /> Oevcrett PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PER671T IS ISSUGD AND TNEREAFTER 'S TO <br /> 3200CedarStreei BE DIL:GENTLY PUFSUED TO COMPLETION.THIS PERM1IIT MAY BE <br /> EvereU.R'A 99201 CANCELLED BV THE CITY UPON ANY STOPPAGE OF 1NORK ON THIS <br /> Phone:259�P810 pqpJLCT OVER 90 DAYS DURATION. <br />