Laserfiche WebLink
(P) 425-257-8810 <br />PU�IC WORKS PERMIT A�LICATION <br />CITY OF FVERF l � PFRMIT SERVICES <br />3200 CEDAR STREF T, EVERETT, WA 98201 <br />FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />I SITE WORK / RIGHT-OF-WAY APPLICATION INFORMATION � <br />DESCRIPTION OF WORK: <br />i���-[_- i�,�,, F�ii�(- JL i <br />❑ FENCE IN ROW %�L' FT IN HFIGHT <br />❑ DRIVEWAY APRON / CURB CUT �� FT WIDE <br />❑ ASPHALT / CONCRETE PAVING ��E�! SF <br />❑ RETAINING WALL / ROCKERY IN RIGHT-OF-WAY ��%' LF <br />❑ RETAINING WALL / ROCKERY OVER 4FT IN HEIGHT /� � FT TOTAL HEIGHT <br />❑ CLEARING / GRADING / FILL / EXCAVATE 1 6�% CY <br />❑ CUT/BORE IN PAVEMENT (PARALLEL) <br />❑ CUT/BORE IN PAVEMENT (NON-PARALLEL) <br />� <br />C�' <br />LF <br />LF <br />ACKNOWLGDGFMENT: 1 have reviewed this application and confirm the information contained herc:in is true and correct Worlc Uone pursuant to tnis perrnit must <br />comply with cunE�nt federal, state, ��nd local law_ 7he g�anting of a permit only authorir�:s approvcd work and no deviations the�elronr Deviations niust fi�st be <br />authorized in writiny from the Building Offir,ial before being authorized under any circunistance 1 arn the owner, or 1 am authoriied by the owner of this property to <br />perform the woik for which application is rnade, and I comply with the State Contiar,tnrs l.aw 1t3.2i RCW ��nd '196 200Fl WFlC. <br />Gty v( l verett Official Use Only <br />PFRMIl #1 <br />. <br />.` , ���� 4 r- �� PW I6oI-oo8 <br />�� � � � � � � <br />� ` - � � �, <br />wnerlAuthorized AgentSignature Date (hevised 10.'1;�:_��I:�) � Z <br />