Laserfiche WebLink
i <br /> � <br /> D818 I � > a„n:��;wo,xs Ne,��e= __.___ . <br /> AFAlicatlo•. For e�au�oep� r � 3-s Z-3_ <br /> PUBLIC WORICS PERMIT PubT0181F e`•. : -- _ <br /> �ess ncc�vee v,m t <br /> Print or Type Only � ea�e��o�a 3—_ __ <br /> _�sUL C.oX /9oZZ. ?,Q.Qr►ts - .�'rTl 3.s�3-��3cj i, <br /> Owner MaiFng Address Ciry Zip Phone �, <br /> �OODe e�rT, Co. 5�3� //4�'A've/(.c L�C STPs�e�s 95�5� �s�3s'/-916 z � <br /> App�icartt Mailing Address Cit� Zip Phone � <br /> n <br /> R <br /> Describe Proposed Work .�ebvrl� o2i xa�,��� .. <br /> -� �t <br /> -- r -1 <br /> N S <br /> � <br /> .�n L�� -- W �� <br /> Project ACdress(if known) ��� �/�-�` S.�f��-�C� � O� <br /> Attech four(4)copies of plans for proposed work-Drew to scale and note the following as appliceble: � _� <br /> • Property Lines ��Centerline oS street � m,.. <br /> •Outline and dimensions of all existing and �'rniicate North C = <br /> proposed structures on the lot •�.SMpw ar.y proposed grading chenges � _ <br /> • Existing and proposed utilities •�S.iow meas��rements � .. <br /> 1 � <br /> DO NOT WRITE B - O THIS LINE K <br /> � � <br /> �p <br /> PERMIT CONDITIONS . � <br /> 1. All calls for inspection shall be mede 24 hrs in advance- phone 259-8815. � m� <br /> ?. All work shall be pertormed in accordance with this permit and current City of Everett Design and Constiuction N <br /> Standards and Specifications. � <br /> 3. Ca!!Location Underground Service 4B hrs.before you dig.TOLL FREE NUMBER 1•$�42r4•5555. i� =N <br /> '^N <br /> �D ��!/dG/� ��i�.�'S �t�ie'/�l�� ��7�i%iE'�) � �m <br /> �" _ ��//�� �` � � <br /> ♦�� : <br /> V� "� <br /> : <br /> � � <br /> 0 <br /> � � <br /> n <br /> rn <br /> ACKNOWIEDGI�MENT OP CONDITIONS <br /> The andersigned owner/applicant hereby agrees ro holtl a�tl saae harm- <br /> - � less the Ciry uf Everett hom any antl all dai��js ror damages, costs, <br /> expenses, or r,auses of action �het may arise DNC9LSE O� ins�allation <br /> and maintenanca of the improvertrent or other ngfii�-of-way use hereto <br /> apphied for a�d �urther agrees to �Emove same upon nc:�ce lrom the <br /> Approved for Construction Date City and to replace public prcperty damaged thereb�:y. <br /> FINAL INSPEC710N Date — <br /> App�oved as Constructed Signature of qpplicant Date <br /> everen PUBLIC WORKS DEPARTMEf�T WOFK AUTHORIZED BV TH�S PERMIT MUST BE STARTED WiTHIN <br /> O 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREP�TER IS TC <br /> BE DILIGENTLV PURSUED TO COMPLETION THIS PERMIT MAV BE <br /> Everett,WA 98201 CANCEILED BV THE CITV UPON ANV STOPPAGE OP WORK ON TNIS <br /> Phone:259-8815 PROJECT OVER QO DAVS DURAi�ON <br />