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r, - --- — <br /> . . .x ��- _ . .., , . .r. .. �)� , en.,p�..�f�i.��-_�.�ItiY��q�<. .�f'�yy`.��E"'3 r�� -,y , _. 's.. <br /> x � <br /> (/��� �� � ci 9 Q <br /> �8�@"—f���ry • . • � .. .PuEuc WOA�Permil• //`��� <br /> .o Application For eiaa.o.o�.. <br /> Pli�3LIC WORKS PERMIT P�����W��•F� <br /> ^ iotnl Fee s <br /> pLena�ool.Fee Va�U s I <br /> C� O Balan<eDee f -�� Z� <br /> Print orType Onl�e $ � � o., T� QnSTING ��-�`��� `� <br /> ^+ CJ � �O <br /> N Y f�) � O <br /> .-� M .-� 1'� <br /> �Y M M M <br /> hlMB.Y-LG�/-�1 � �1��1��r, �v�--.f-� n.v,L� �� ���� <br /> Owner a � r: o � � alMng A dress City Zip Phone <br /> r� g� � a � c'3 <br /> � �/$� � aa. � ciA�l l� A� fi-f3�1!/� <br /> n plicent Mailing Atldress City 2ip Phone � <br /> . Describe ProPosed Work ���C�'1'_�3�1,"�" ,�/,�S���i�r-.r'-���/ T Gf11///1/r /ilil/r���/3GY/�' <br /> lrz�i��/��ar�?��4q <br /> W <br /> Project Address(if known) � � - - -� � <br /> Attach four(4)copies of plens for proposed work- DraN•to scale and note the following as applicable: � <br /> � • Property�Aes • CeMerline of street � <br /> • Outline and dimensions of all existing and • Indicate Norih <br /> proposed Fjfuctures on the lot • Show any proposed grading changes <br /> � Exiating and proposed utilities • Show measurements � � <br /> DO NOT WRITE BELOW THIS LINE <br /> � � PERMITCONDITIONS O <br /> 1.All calls for inspection shall be made 24 hra.in advance-phone 259•8810. � <br /> 2.All work shell be pertormed in accordance with this permit and current City of Everett Qesign and Consiruction <br /> Standards and Specificatlons. <br /> 3.Call Locetfon Underground Service 48 hrs,before you dig.TOLL FREE NUMBER 1•800•424•5555. � I <br /> � PUC �r.n doi� �niPe fo h4✓e a h,;�..���. �f' O <br /> 3� o�' Lorier� o��-�,,�ise �e Concrc2'P cv" .d�f�.fe Tron. <br /> .'S /f1osY�/L�Tu`/[.vuM' C'a,7'��i�a�a��,. �o lxe .ti-,-d���U-'c4' mt�CLj u/c�.P/ � <br /> 0 r <br /> �Jo��.� �rlas� ho�e a.. �c��G,�e h�a�Pr;aL Sc�ocrafar � � <br /> C c�� Sfa n�vn� #5�/U. <br /> �, jrre�Gf.�Y' lixs Musf 6c :ny-�afl�d oti ;or.vo7�e �Orv�er,7�y� O <br /> G'o.�suf� �'ill B.r�ce � W�!� f/,� C%�ya�E�v�re7f' �.Xt fer a <br /> Q/e��`- �.�'pr Q. ['onsuCf2f.or an Ba .r�f�lx./ P�'evIInfion . <br /> ' 7 LtJOr.E fo 6e done /1e� ,oloes oo��,-o,�d 6y fhe C'i�� �u6l.c I <br /> (Jpv,ES IJ¢�7� �� S ��9-�� �a�*/�•7,S'�izC�i�CKNOWLEDGEMENTOPCONDITIONS ���- � <br /> : � <br /> The undersigned owner/applicant here6y agrees to hold and yt�. <br /> less the City of Everetl Ircm any and all claims lor da���}}} ,�p�} , <br /> ezpenses, or causes of action that may arise because �i tall�l�on <br /> ��.� ,"' and maintenance ol ihe improvemen� or other right-of-wa e�reto <br /> applied lor and furiher agrees to remove same upon n ice ro the <br /> Ap d or C i on City and to replace public property damaged thereby. <br /> ���C� GGN�'7- �7�'�7V �U17- /�/i�h�/�NrJ <br /> � �7 ���� <br /> FINA L I E C T I N a t e /"y ^ �� <br /> ��-��1�/l�� s.!� <br /> Appmved as Constructed (Sii nature of Applicant ���- �/ py�e <br /> � PUBLIC WORKS DEPAFTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 180 DAYS OF DATE PERMIT IS ISSUED AND THEqEAFTER IS TO <br /> 3200 Cedar Sireet BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MA}' p[ <br /> Everetl,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> � Phone:259-8810 PROJECT OVER 90 DAYS DURATION. <br /> I <br /> —__--__.___—_ -__.._ ___--___-- _-__—___-_—___.__— _--_._. - __. -_-i <br />