Laserfiche WebLink
rymy <br />y zH <br />�C c� <br />y0 <br />O x0 <br />'i1 H'i <br />CA H <br />no3 <br />H t7 <br />OH <br />:z 08 <br />>H <br />t" H H <br />H <br />A Cqq7 CA <br />CA <br />r-3 O rn <br />xM ' <br />�� <br />ksPe,mle <br />Date 1 <br />e <br />Application ForWORKS <br />PERMIT <br />LD'dgDept <br />ae8 <br />ke Fae $PUBLIC <br />¢ <br />fee Pepeue <br />88 <br />I <br />Print or Type Only rr�rr�t <br />m <br />r <br />Describe Proposed Work <br />Project Address (if known) 1.,.. <br />plic <br />Attach four (4) copies of plans for proposed work • Drew to scale and note the Centerline of sleet able: <br />Y • Ptoperty Lines • Indicate North <br />• 4tline and dimensions of all existing and Show any proposed grading changes <br />_ proposed structures on the lot • Show measurements <br />• Existing and proposed utilities <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. it advance • phone 259.88y of <br />2. All work shall be performed in accordance wi <br />—�th this permit and currant City of Everett Design and Construction <br />Standards and Specifications. <br />3. Cell Location Underground Service 48 hrs. bolare you dig. TOLL FREE NUMBER 1.800-424-5555. <br />'sillillikall <br />__ <br />Ili <br />'— — <br />,0rlk � <br />Lo <br />v� <br />662 3V 46 X -/9-931 <br />I <br />FINAL INSPECTION Date <br />Approved as Constructed <br />'All PUBLIC 3201C WORKS DEPARTMENT <br />320T Cedar Street <br />Eve, att. WA 98201 <br />Phone: 259.8810 <br />tw <br />ca <br />0 <br />Z <br />0 <br />0 <br />13. <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm. <br />less the City of Everett from any and all claims for damages, costs. <br />expenses. or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-of-way use hcreta <br />applied for and further agrees to remove same upon notice from the <br />City and to place public property damaged thereby. <br />-mil to Zt 91 <br />r— DaT� <br />Signature of Applicant � <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED By THE CITY UPON ANY STOPI AGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />