Laserfiche WebLink
Date �O/�� 44 PUEIic Worka Permit• 94,/2oZ <br /> Applica�ior�For TO POSTING �`G ""7- � Biec.oePi.• <br /> PUBLIC WOR�CS PERMIT Pub6cWorkSFee <br /> � Total Fee S <br /> p Leae Appt Fee Paia S <br /> Print or Type Only � � � e,�,��,o�a s ��� 'S8 <br /> � M � ('n-Q�lcn9 002- 322 %Fi'83/ <br /> Terranom'cs 37.o IoBtt,�N � ~SG�te �'4D� 6elledue lVash�nQEa, 98Ln4- ��- <br /> Owner Mailio�\g Adqe�7 Gity Zip Phone <br /> � � � � <br /> Applicant Mailing Address City ZIp Phone <br /> Describe Proposed Work f�EA��t�Y`OTX.._� _LY'GS � EX�iS�I'Iq na �P t 8nd �rk',i <br /> �o oh�ta;n �.-3 % ctrade for pnant Upqrad2 ex;�.�na storm dn�in <br /> s ste . Mod'��F ; �I E�r: '' <br /> Projecl Address�if known) ���_ � <br /> Attach four(4)copies of plans for proposed work- Draw to scale and note Ihe following as applicable: � <br /> • Property Lines • Centerline of street � <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed struclures on ihe Iot • Show any proposed greding changes <br /> • Existing and proposed utilities � Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <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 perm(t and current City of Everett Desfgn and Construction � <br /> Standerds end Spocifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUM6ER 1-800-424-5555. <br /> �• As pera�oved plans cla�-,ed � �/zo/q4 Z <br /> s• ��re�oP�r v�,c,-�e,-st�.�ds �k, -Y�►� ur�o-F' 0 <br /> �h� S �n��-� cJoes n p� i h G�Uc�.C>. ��'1� GOS� D-f- �"1� � <br /> G��ies ��ork -Ip iv�5��1 �(� on ���cr rna��� -�'or -��v� <br /> s.e.rv �rz �,.h d e,�r'e�s -f�o �J -For c�� �P ��n,v r � <br /> � �u o r k b e� n� �v�o r r�ed b� �1� c�wc , O <br /> a <br /> ACKNOWLEDGEMF_NT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> � less ihe Cily f Ev �rett f om uny and all claims for damages, costs, <br /> �) . ezpenses, s of cti n that may arise because of installation <br /> ��� � and maint e f th im rovement or other righFot•way use hereto <br /> applied u He a ees to remove same upon notice from the <br /> Approve for Co n Dat <br /> / City an I ce u li r perty damaged ihereby. <br /> .� .��=t-=------ . %-/ 7- -�i�- <br /> FINAL INSPECTION . ate �O' 2� ^ 9't- . <br /> - Approved as Constructee: n of A ican Dale <br /> ���� PUBLICWOaKSDEPARTMENT WORK AUTHOFIZE THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS �TO <br /> Everett,WP.98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:�u9-8810 CANCELlEO BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />