Laserfiche WebLink
; <br /> ,, , ���2_ <br /> Date��9 S �� <br /> Pul�l�c Wm�s Pnrm�� <br /> ' Application For i� F���+�� oro� • .. ------. <br /> PUBLIC WORKS PERIII�IT �ublifWO�hlfY9 --- <br /> ¢ .,�a��.� s. <br /> � iess eoni i.P ra,:� S <br /> Print or Type Only r � � ea�r�.�o��., S—�D� <br /> c� o o ppZ-3Z2yo//93/ <br /> « b � <br /> TC� c�< �v�h�a� h� h W 7 a " �., � � �c ��, �f S�o 3 �s���,3 <br /> OWnei A9a�hn�� 4rldruss � ��t !iP Phnnr. <br /> $ � �t <br /> --�-��cu r���—���-���������.�-- q�d�.�C� J��� <br /> Apphcant M.�d�nq Atltlrrss G�v 7_iP Ph nP <br /> Desc�ibe Proposed Work __� '�� _ �'f��(/(� <br /> C-u1r � ' —�-1��(2�iLGGvs�---����--- <br /> ---- ----------- <br /> --- . . - ---- �`Y, ��!J W <br /> Prolect Address Id known! .�7 Q_Q____���(�' ,_'__ � �/(��i(1 Wa�_ � . <br /> �.Y�_..___._�__.__ <br /> AffOch loUr(4)coP�es ol plans lo� Prn�;oseJ work � prav� to .c,il...,.,i n,:tc ih,�lo�luwmg.]5 dpUhr,�hlp.: — <br /> • Property Lines • G;nterline nl street � <br /> � Outlme and dimensions o�ali exishng and • Ir.dicate Nnrth <br /> proposetl struclures on ihe lol • Show any r.roposetl pratlin9 chanye5 <br /> • Eristing and proposod ulilities i Show measureinents � <br /> DO NOT WRITE BELOW THIS LIPlE <br /> PERMIT CONDITIONS O <br /> ��1.All celle for Inepactlon ehall be metle 24 hre.In advance-phone 2b9-8810. � <br /> 2.All work ehall be performed in accordence with thia pe�mlt and current City of Everett Dealgn and Construction <br /> 3tandards and Specilicatlons. <br /> 3.Cell Locatlon Underpround Service 48 hre.belo�s you d10•TOLL I11[[NUM�t111-800�424•SSSS. � <br /> O <br /> INITIAL INiNrOt10N � <br /> KIRK BROOK� � <br /> DATE �7T9 S O <br /> � <br /> ACKNOWLEDG[MEN7 OF CONDI110NS <br /> �L� The�,ndnrsiqnetlowner/dpphcanlherebyagreestoholdanAsaw �arrn� <br /> �---�-�� ---`� iess ;he Gty o� Everet� Irom any and all claims for dam;�qc.. ;.ns1s <br /> � � �*I����se,. or causes ul actlon that may anse because ol insuilrit�on <br /> —/'C / � ' i and mamlenanr.e nl Ihe improvement or olher n9hbo6waY usr he�rto <br /> . I �ppl�er; lor and luriher ac�ree5 lo temove 58mo upon no6ce I�nm ihN <br /> Approved lor Co Iru n Datu � �,�y,����� ����,ul:aca uubLc pronerty Jamaged Ihereby <br /> i <br /> ``-� G. l=��— � <br /> FINAL INSPECTION Dale <br /> Approvad as Consfr�clod S�gnalure ol Applicant Date <br /> � PUBLICWORKSOEPAHTMENi WORK AUTfiOR�ZED BV THIS PERMI7 MUST BE STARTED WITHIN <br /> 3200CederStreet �9� DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA9B201 BE DILIG[NTLY PURSUED TO COMPLETION. THIS PERMIT MAV 8E <br /> Phone:258-BB10 CANCELLt �BY TNE CITY UPON ANV STOPPAGE OF WORK ON THIS <br /> aRO.IECT OVER 90 DAVS DURATION. <br /> i <br /> i 'i <br /> / <br />