Laserfiche WebLink
��� <br />ro <br />O H <br />Y H V� <br />� <br />� H � <br />O tt O <br />R1 N M1 <br />N H <br />� H � <br />O I-1 <br />z n o <br />N �q O <br />� • n <br />zy r+�1�� <br />t� y 2' <br />M H <br />O N <br />O M <br />Q C N <br />��Cr-0 <br />H O N <br />i �o_..i, <br />'a r <br />__ <br />i !-�'. <br />Date 8-5-92 <br />App�ication For <br />PUBLIC W'ORK� PERf�iIT <br />Print or Type Only <br />Brian Olson <br />Owner <br />6928 Evergreen[day Gverett 98203 353-4533 <br />Mailing Address City Zip <br />PWLc Works Paimil • <br />OICg OepIJ i%(i2�% <br />Puohc works Fco <br />Talal Fco 5 <br />Less Appl Fee Pma 5 <br />Baiancc ��a S <br />Gregg Ortega 347-1733 Spartv's <br />Applicant MailingAddress City Zip Phane <br />Descrihe Proposed Work CommeTCial additi.on <br />Projecl Address (il cnown) <br />Attach four (4) copies of plans lor proposed work - Draw to scale antl note the lollowing as applica6le: <br />• Propert � Lines • Cenrerline of slreet <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on ihe lot • Show any proposed grading changes <br />• Ezisting ar:d proposed utililies • Show measuremenis <br />BELOW THIS LINE <br />PERMITCONDITIONS <br />1. All calls for Inspeclion shall be made 24 hrs. in advance • phone 259•8810. <br />2. All work shall be peRormed in accordance with this permit znd current City of Everett Design and Construction <br />Slandards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. <br />PUBLIC WORKS PERMIT <br />N T P <br />B Y �� <br />D AT �a� �� <br />ApproveC lor Construction Date <br />FINAL INSPECTION <br />Approved as Constructed <br />/� PU6LIC WORKS �EPAR7MENT <br />j 3200CedarStrcet <br />� Everclt, WA 98201 <br />Phone:259-8�10 <br />Date <br />Z <br />O <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersi9ned owner/applicant hereby agrees to hold and save harm� <br />less the City ol Eve�elt Irom any and all claims lor damages, costs, <br />expenses, or causes of action ihal may arise because ol instal!ation <br />and mainfenance ol Ihe improvement or other dgh4ol�way use hereto <br />applied lor and lurther agrees fo remove same upon notice Irom the <br />City and to replace public properry dama9ed thereby. <br />Signature ol Applicanl Date <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 STOPPAGE OF WORK ON THIS <br />PROJECT OVER 9U DAYS DURATION. <br />