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CLEARING, GRUBBING, GRADING, AND EXCAVATION PERMIT <br /> Type or print clearly in ink i <br /> PRESS HARD-VOU ARE MAKING COPIES ��. � <br /> i <br /> i <br /> Public Works ��� _ � <br /> Everett, Washing;on <br /> PERMIT NO. . <br /> APPLICANT Nndersigned) AND FIRM REPRESENTED, IF ANY:. � � <br /> HEREBY APPLIES FO? PFRMISSION TO (ldentify Quantiiies) � <br /> FOR <br /> OFFICE AT THE FOLLOWING LOCATION (S) - <br /> USE <br /> ONLY <br /> DETAILED,SCALED DRAWING OF WORK TO BE DONE,ATTACH 4 COPIES � <br /> ATTACH LEGAL DEoCRIPTIONS <br /> PERMIT IS VALID FOR 120 DAYS ��-��'4� �•• <br /> (May be extended upon written approval from Public Works) � �. �. �. . : � ���.sGilth<� <br /> ao 2oacl> � enst� �iy �P ",.:� <br /> T' <br /> , ..�.i':? �.Y'FAS�: Ov �tia1t8Y .. <br /> A NEW PERMIT IS REQUIRED IF WORK I <br /> HAS NOT BEGUN WITHfN 60 DAYS 1 lh`-' E 7��'"'1 + st�t�ixl�' ��� <br /> ,tlactle� Cc�p(; li:cr3 v�: <br /> a,�i,t; al.. �:vcr�rean� a[ ,! pt <br /> THIS F[RMIT TO BE POSTED ON JOB SITE . �n��;3.R_r. <br /> CALL FOR INSPECTION 259-8811 =tf:udl <sCris�''-'�.LCL"iU!1 ?�'J.l.l : . . <br /> , r . �fie�l�� �=on:gl�r, coarr-� <br /> 24 HOURS BEFORE BEGINNING OPERATION . �Y ` �1�,;�,red. ::tre � . � - � � <br /> .i i:; esLi[;ial�i! .+ . <br /> ,,;_�:,_ •-<� �-��r,��� ..�<.-�- - � The undersigned owner herebY ayrees to hold and <br /> .sve harmless the City of Everett from any and ail <br /> . . ' � �� claims for damages,cosY.expenses,or causes of <br /> action that may arise because ef the cleariny. <br /> grubbing,grading,ano/or excavation activities <br /> hereto applied for and fwther agrees to comply <br /> PLANN.ING/SEPA APPROVAL with all provislons of this permit. <br /> � Sigr.awre of 9pplicant/Date of Application <br /> Adtlress <br /> -- CitY Zip <br /> Approved for Construction (PW) . <br /> Issu?d � e ) <br /> Date Telephcne Number Altematz <br /> G�� - �_�p.�-= -�1���Z-- - -- <br /> � A ovec s Constnir,[ . FEE <br /> / <br />