Laserfiche WebLink
_ � :�_�_ . - , . __'__. . . "" ' _ ,, . �..1. ��y-^'� <br /> _ ' . � ' ,. 1: �„i� . _ � E. .'4C . + ' ' � <br /> r+' . . ,— � .. � � �� �y7S <br /> 1i f [x� } � � �J� <br /> Date1 � ���J \Nu�ncWoksPnrm� ����� �/J.(�1I�� � �� <br /> Applicalion For <br /> BinN Deui • �'�L�-7�J•!..I—_ <br /> PUBLIC WORKS PERMIT PaGhcWorlsfrp s — <br /> TOIPI FOC — <br /> leaslnnl FeePeid s_� <br /> Print or Type Onry �+�,�=��o��,. s 2/J� <br /> �)llu���'�'S :�-i ) `,�a1 ?�1C�.�—� ) �1� ' )��r l d'li� �� —►'�,�� �5��1�� <br /> Owner Mading�ddress Ci y � Z�p � Phone <br /> '_( �j � �� /—�r7 �� !/1,11� - - — <br /> Ap�icant �ng Address ;,��y Z�n Phone <br /> Describe Proposed Work _�L�� 1�� y�� � t( � <br /> Prolect Address�il knownl �- � %�_ !2F/'% �I L•'� � <br /> � ' � <br /> Attach lour(4)copies of plans for proposed work- Draw�o scale and note the!ollowing as applicable. � <br /> � Properry lines • Certerline ol street � . <br /> • Outline and dimensions ol all ealsting and • Indi:ale North <br /> proposed structures on the lol • Shnw any p;oposed gratling changes <br /> • Exisfing and proposed utilities � Sh��w measuremenis � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> � 1.All calls for inspection shall be made 24 hrs.in odvance•phone 259•881 O. � <br /> 2.All work shall be peAormed in accordance with this permit and current City of Everett D�sign and Construction <br /> Standards end Specitications. <br /> 3.Call Location Underground Service 4B hrs.before yov dig.TOLL FREE NUMBER 1•800�424-5555. � <br /> /, YQ/�n.i�lirlq � X�<a L.a�.r,fi��CJ�vi'a ,/;:.��•�'"ih: � i' 2�-r�`�S.�t7f'c.,+,r/. ':�_. O <br /> O/Hd'" iJrfR/! ��2r'� �O /J.c �l�70-[�y�.4 �Y 2 G2.�L J�C/�t�{/, <br /> O �� <br /> .S Sau/C�„r �..�,� 2v�ln-c� �� l � �»,� ,vs^���:; � f1oo�F.. . � <br /> f.� ��L^ ,_ �c , , tt`� �„� , > ' :�,. , -,'. �'i� �� ���-- �-!�. /,.,� .l�t:��1 V/ <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> 7n�r undr.rs�9ned owner/applicant herebyae�rees to hold and save harm• <br /> Iess �he City ol Evuett �rom any and all claims fo� tlamages, costs. <br /> ezpenses. or ca�ses of action that may anse because ol ins�ailation <br /> �� ���� and mamtenance of Ihe �mprovemenl or other nghbof•way usc hereto <br /> - ^��' � applied fOr and lurlher agreec '� remove same upon notice Irom Ihe <br /> Appr Jed'lor/Can tr�y / Date C�ty and to replace public proputY damaged Ihereby. <br /> l r <br /> �T� <br /> FINALINSPECTION Date ' G�1�u*q �.,�Gr�'.rr+�c�,- �- ,�L' -��/ <br /> Approved as Constructed �i nature of App6canl Dale <br /> eveiett PUBLIC WORKS DEPARTMEN7 �ORK AUTHORI2ED BY THIS PERId1T MUST BE STAqTEO WITHIN <br /> � 3200Ceda�Sireet 180 DAVS OF DATE PEfiM1T IS SSUEO AND THEFEAFTER IS 70 <br /> Everet4 WA9B201 BE OILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE I <br /> Phone:259•8810 CA4CF_LLED BV TNE CITY UPON ANV STOPPAGE OF WORK ON THIS <br /> PROJcCT OVEF 90 DAVS DUi7ATION. I <br />