Laserfiche WebLink
Dete.'j��B PuElic Work�Permil• �`� ���/ <br /> . Applicatlon For BICp.D�pl.• <br /> PUBLIC WORKS PERMIT ��TOI�F�eFa� � <br /> La��Appl he P�iE / A <br /> B�I�ne�Du� • LQ�- <br /> Print or Type Only <br /> F/BR►�N�mSo� �ar �3�� i/BRANHn>Sen �ocerit ���a/ a.si-.3Af'�— <br /> Owner MeiHng Addreae C�ty ZIp Phone <br /> �8Pl�Nsi,»S /� °XiMu�/ ,SN,no. .S�.n � .ria...:�. �Sea•^ '"' <br /> AppllCant Mailing Addresa C�ty Zip PhOnB <br /> DncrlMProPosedWork A ���n.� -{�' �i'iva u�a� �r prv���aC GnOf/vr RCc�paJ 7�0 .S}�roe� <br /> = W <br /> Wo{�et Addrw(if knownl 3 ✓��'.SOn 31 19 ��O / � <br /> Alt�e�four(�)copls�ol D���s lor propoae�work• Draw lo sealc and no13 the lollowinq as epplicable: � <br /> • Property Linae •Cenlerline ol nlreet � <br /> •Outline�nd dimenelons ol all existlnp and • Indicate No:th <br /> proposed atructuros on t�e lol � Show eny propoaed prading chanpes <br /> • Erltlinp and proDosed ulllltles • Show measuremenle � <br /> N I L HI LI O <br /> PERMIT CONDITIONS <br /> t.All cNb for InW�ctiai�h�ll bs m�de 24 hrs.in edvance•phone�aase�o. ' <br /> 2.All work M�11 W p�Aormed In accordence wlth thle permit and cunent City of Everett Desipn end Conatructlon <br /> Stand�rd�md 8p�clliculons. <br /> �.C�II Loutbn Undsrpround Servlce 4B hro.before you dip.TOLL f11EE NUMSE111-90P4Z466ab. � <br /> O <br /> � <br /> � <br /> O <br /> a <br /> 09/13/88 1�12PM OOOIiN2495 x#I <br /> � ACKNOWLEDQEMEI�If OF CONDITIONS <br /> Tf�e undersigned owner/eppll�a0roas to holJ and save heim• <br /> — I�,se Ihe City of Everett Iro�nd all{Qb�lor damapa& coe10. <br /> oxpeneea or causes of ectl msy af�ii ceuse af Inetallalion <br /> _ _ L� �� �8 and malntenance ol the Impr nt or oTIFBr ht•ol•way u6e ha�elo <br /> Da��� appued lor end Iurther ayrees Io ramove wme upoa ootice irom the <br /> Appw�O for C ru n Date City and lo replaee publle property damaped theraby. <br /> L«� �- T/• f F <br /> FINALINSPECTION Date ��� ��+��`��"—���' ��`��5� <br /> Appowd��Con�tructed I ature o pplic nl Date <br /> ��ry pUBLIC WORK9DEPAtiTMENT W�RK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHIN <br /> ` ������� 1B0 DAY9 OF DATE PEFMIT IS ISSUED AND THEREAFTER IS TO <br /> BE OILIOENTLV PURSUEO TO COMPLETION.THIS PERMIT MAV BE <br /> �`, EwMR WA Yl201 CANCELLED BY THE CITY UPON ANV STOPPAUE OF WORK ON THIS <br /> ���25��� PROJECT OVER BO DAVS DURATION. <br />