Laserfiche WebLink
�!y i� ncwKai�r�u Sl ! Z.� <br /> �,r <br /> PUBLIC WORKS PERMIT oe�e <br /> PUBLIC WORKS DEPARTMENT Public Nbrks Permit A <br /> 3200 Cedar Street <br /> Everetl,WA 98201 259-8810 <br /> Building PermH N <br /> IYPE OP PRINT ONLY Publie Works Fee S <br /> � �v1n 1►'rt�ln-/�/�Y'qG�u �f27 �2kcv f�v+� �'82D/ _ 2-7�/ <br /> � Owner Mail�Atldress Clty Lp p�q� <br /> , �� � � <br /> i Applicant MailinpAtldress t;ity Zip Phone <br /> + p Z � /L°��__ N�n�,. U/u�!l � ��" �G.�_?� <br /> � Describe Pro osed Work <br /> ; _.YL'cCSSrI� 3�.����C»�,n��G 5/GI AIC.� � � <br /> � ' � <br /> Jnl�li� ,,• f� k��c � <br /> FROJECT ADDRESS(if known) �S a��(/"C� <br /> Anach lour(4)ccpies of plans lor proposed work.Draw to ecele end note the follo•.vinp N applkablo: � <br /> �Propprty Lines �Outline end dimenslons ol all exlsting and proposed atructures on the lot •Exlslinp and proposed utilltiea O <br /> 'Centerline of etraet •Indicate NoAh �Show any proposed gradinp ehanges •Show measuremenia <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspect(on shall be made 24 hours In advance-phone 259-BB10. <br /> 2.All worY,shall be performed in accordance with this permit and current Clty of Everett Design and O ; <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before yuu dig. TOLL FREE NUMBER 1-800-42M5555, � <br /> � <br /> ';IRLI(. ��ORKS PFNrti' awll�r pRK, '�� , a <br /> h,0i FF.GUIREI� lY <br /> a y--�- R� " <br /> �t r <br /> �ATE ._S_ QB '��._.._ <br /> -- -•— AutTE„ ""d—`;. <br /> -�,.�..L,� <br /> � ,�-�'• ydnr.it Gar.Gvk—Ct�� "/�a'� <br /> Grh!'�' WOU�� N0�' f]c h¢CQIt�Q�� <br /> ACKNOWLED(3EMENT OF CONDflIONS <br /> The undersigned ownedapplicant heie6y eprees to Iwltl arM eava harmlese <br /> the Ctty ol Everetl lrom any end ell clalma for damepea,costs,expenses,or <br /> Approved for Conshuclion Date oauses of eetlon that may arlse beeeuse o1lr,stallatbn antl malntenance of <br /> iM Improvament a other right-oi•wey use hereto applietl fw erW further ag'ees <br /> to remove same upon notice trom the City and to mplace public proparty <br /> tlamaged Ihereby. <br /> FINAL INSPECTION Data <br /> �proved as Constructed <br /> Signeture of Applkent Data <br /> WOFK AUTHORIZED BV TH�S PERMIT MUST BE STARTEp 1VITH�N 1B0 DAYS OF DATE PERMR IS ISSUED AND THEREAFTER IS TO BE DILI6ENTLV PURSUED TO <br /> COMPLETION.THIS PERMIT MAV BE CANCElLEO BY THE CiN UPON ANY STOPPAGE Of WORK ON THIS PROJECT OVEH BO DAVS DURATION. <br />