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Date 7-11-94 <br />s0 POSTING 3-�0-� <br />qpplir,ation For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Royce Ferguson 2931 <br />Ownei <br />Owner <br />qpphi.ant <br />�+:,�:��.; n,:�v,•55 <br />� � <br />� I _�,�/2 3 O <br />x P��I11�ClYO�hSPnrmil• <br />oian o�ni � 43834 � <br />� <br />�O <br />7 <br />� <br />0 <br />8 <br />� <br />�, <br />N <br />�� <br />lil M <br />M <br />r,�ia�r,wonsFre 5 _—_—'_'___ <br />,�„� F�„ <br />�.,,,,>�,�,� �,..,��:,:, s <br />�.,�.,,,�„ ���, s 3S— °�_- <br />-3�z5�'oiig3 / <br />� � r„���„� <br />�s' � � �4��}/ /YI�Cu llotl� .388-9833 <br />PP.,�Ir�:lAddn•55 _—'__--.'_�i,V ZiP <br />site work � _f��v�._a-r�G---6C�ind __6[ti�fl%��—. <br />Describe Propos^d Work - ---- <br />Prolect Address Id known� <br />2931 Rockefeller Ave __ __ __ _ _ <br />Attach four 141 coPics ot P�ans In� nronosed wor.. � ��nv. Io .:�,i'. <br />• Propeity Linos <br />• Outline anA dimensions o� all exivhn4:�nd <br />proposed structures on the Ioi <br />• Existing nnd proposed utilities <br />.c�a ne.ti� Ihi, !uqewiny as aoUhcahh, <br />� C���:^.rhnr. nt s;reel <br />• I^.tlir.al•: No��h <br />� :�,ov: airy r.roposed gra7mi� cnanqrs <br />• Shnr; mnasurements <br />iH15 L <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance • phone 259•8810. <br />2. All work shall be pertormed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specitications. <br />3. Call Location Underground Service 48 hrs. be�ore you dig. TOLL FREE NUMBER 1•800•424•5555. <br />7 i�4 v.�� fo G� <br />an 7-//-9f� <br />�oPy �fa��d) <br />do�+�. ,Q.a�z. ,2�an.. �P�-ov� d �� <br />vy f%J'� �✓f�^r'� f�J��G Lf/Or,�s O'NP�. <br />� <br />' FINAYINSPECTION — <br />qpproved as Gonstructed <br />�A`�,� PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everetl. WA 98201 <br />Phone:259�8810 <br />� <br />O <br />ACKNOVJLEDG[PdENi OF GONDITIONS <br />i h„ u„dr.i.,anetl owneUapPlicani hr�eby a9rees lo hold and save harm� <br />-- - --- . ir;;s ;h�� Gdy o� Fvi�relt Irom any ,vnd all c�aims for tlamages. rost5 <br />�. �.,prnso� ar causes of action that maY ariss Uecnuse ol inslallatwn <br />/ ,/ ,�nd mainlenanGe o� th� improvement or oiher nght-obway use hereto <br />//� _ 9r _ I,�:�,i,ed fa and furiher an�ees to remove samr. upon notice iwm ihe <br />� C:d.� l G!y ���n iaolaca Puhl - crty dama _ <br />i <br />&- �i�-�ry� � <br />Date � — Date <br />� SionaWrc oi AnP��can! <br />j\Vpq1< AUiHORIZFD BY THIS PERMIT MUST BE STARTED WITHIN <br />itq0 DAYS OF DAT[ PERMIT IS ISSUED AND THEREAFTER IS TO <br />� aE D�UGENiL1' PURSUED i0 C0��4PLETION. THIS PERMIT MAY BE <br />rn�dCELLED BY THE CITY UPON ANV STOFPAGE OF WORK ON THIS <br />� P�70.�EGT OVER 90 D1YS OURATION. <br />. <br />