Laserfiche WebLink
�8�e� PuElit Wm4�Vermil♦ v� � � <br /> ��� AppllCation Fof eiap Deo� • �.b9 G Z <br /> PUBLIC WORKS PERMIT PUoiot�FeeF'� • - <br /> �eu�oot fau Pun 5 <br /> Be.ance Due { 2� <br /> Print or Type Only ' — <br /> �Ow r Mailinp Add�.�.ss Cily Zip ZS Phone <br /> -rl�, ,L/n�,T�lC�/ py_pI�,.La t ,.,, , Z�,�1 ii� '"Are NF b'P/IP/l�1�� YS3-93 ZD <br /> Appllcent Malling Ad ress Ci1y ZiP P�ona <br /> I ' r LDT <br /> Deecrlbe Piopoeed Wod� NPuI 4/Al3�L lA� � �A�Q. : ��. ��a� ��� <br /> W <br /> p�o�ett Addroe6111 known) 8��,�"—'���' — H <br /> Attach lour�4)cepiee ol plane lor propoeed work• Drew lo scale end nota the lollowinp as applicable: � <br /> • Properly Linea • Centerline ol street � <br /> •Outline and dimenelona ol ell axleting end • Indicate North <br /> proposed elructu�ee on the lot • Show any propoaed yrading chengee <br /> • Existinp end proposed utllitles • Shnw meeaurements � <br /> DO NOT WRITE BELJW THIS LINE O <br /> PERMIT CONDITION3 <br /> 1.All calle fo�Inepectlon ehell be made 24 hrs.In edvence•phone 259•8810. � <br /> 2.AII work ehall be peAormed in eccordence w!th Ihia permit end currant Clty ol Eve�ett Desipn and Construclion <br /> 3tandarde and Speclficetlona <br /> 3.Call Locatlon Underground Senice 4B hrn.belore you dig TOLL FREE NUMBER 1•800�424-56bS. :: � <br /> C'��� � � !��a� ��� ,�",�0 O <br /> ��t-�� ��,,,._.�� � ,ti�� �' <br /> � <br /> 0 <br /> a <br /> /� ACKNOWL[DGEMENT OF CONDITIONS <br /> �� The undersigned owner/applicanl�^reby ngrees to hold and save hann- <br /> lesa ihe Cily ot Everetl Irom any and all claims lor damapes, costs, <br /> expen es. or ceuses ol action Ihat may ariso because ol irstallation <br /> __��� ✓ ��/ oo and inteneocn of the imP�ovement or o�her ri9hl�ohwaY use he�elo <br /> appli loi and 1 Iher ag�ees to remove same upon notice Irom the <br /> Approved lor Ccn r ion a�e City d to repla p bhc pr perry damaped Ihereby <br /> _��S�G�t�� Y-��l` l� <br /> FINAL INSPECTION Oate � <br /> Approved as Constructed i ture ol Applicant Date <br /> ' RK AUTHURIZEO BV THIS PERMIT MUST BE STARTED WITHIN <br /> everetl PUBLICWORKSDEPARTMENT 180 DAYS OF DAiE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200CederSlreat BE �ILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Evoretl.WA 98201 CANCELLED BY THE CITV UPON ANV SiOPPACaE OF WORK ON THIS <br /> Nhone:259•8810 PROJEC`OVER 90 DAYS DUPATION. <br />