Laserfiche WebLink
•�>�� � _._ <br /> Data%���5 v„oi��wa,..r�,m,�. — . ---- <br /> AiEp Deo� �__-- <br /> Applicntion Fo� <br /> PUBLIC WORKS PERMIT P�m¢wore�Fee —_ _ <br /> Tmtl��a �— <br /> les�A00� Poa P.ue S--- � � <br /> B�ian�e Duo 6 �� <br /> �- <br /> Print or Type Only ���q�— <br /> J'_ �Ru�rv %,�S //'���If}$�'�',l�_ r d'ati.� :i 5'.i-u� �; , <br /> Owner Mailing Address C�ly Zip Phone <br /> G!!L 4FYs�.e GCT, 5� <br /> Applicant Mei'ingAddre3s--_—�--.�ily----- Z'�—�— Phune <br /> E�,"�—�1�_��—��P/ ✓GW�� +?�p� _ <br /> Uescribe PrDyoeoA Work p <br /> A-LSO —1'�1l�_-�'.LL1�-s�-�—QD�=.���' �_!_/� �S'TRrE�T2—�._�— - n <br /> ��lL/��� -- -- -- � m <br /> -- - -- �u ..� <br /> - / '� �.���.r�.��,�y�� F_ � „ <br /> Project Addrasa Uf known) L!�—�--� "' '� <br /> Atlech lour(•t)coples o1 plens fo�p�oposetl wc�K� Draw to scale and nole tl�e loilowing as applicable. �� <br /> � m <br /> � v <br /> • Property Linea • Or.nlerline ol streel m� <br /> • Outline end dimene ons ol all existing and • Indicate North o; <br /> propoaed etruclure�.on Ihe lot • Shoa any propose�greding changes <br /> • Eaisling and propo[eA ullli�ias • Show meesurementa � �} <br /> �� <br /> � <br /> m <br /> DO NOT WRI7E BELOVr THI:i LINE � Q = <br /> C <br /> PERMIT CONDITIOVS , a � <br /> I. All celis lor inapection shall be mnde 24 hrs. in advance� pMne i 59•88�5. �� � � <br /> —� N <br /> 2. All werk ehall be pertormed in ec�ordance wilh Ihi�permit aid r,�uren�Ci�y ol Everetl Design end Consiruchan K T <br /> Stancerds and Bpeclficetions. o� <br /> 3. Call Location Ur�dargrounA SArvice 4B hrs. belore you di{7. TOLI.FREE NUMBER 1•800•424•5555. � <br /> -� <br /> x <br /> o m.-. <br /> � <br /> or <br /> nm <br /> � m �' <br /> z t� <br /> � 1r <br /> m <br /> � <br /> Q � <br /> x <br /> a <br /> � � <br /> x <br /> � <br /> z <br /> 0 <br /> ACKNOWLEDGEMENT OF COND1110NS � <br /> C'1 <br /> , 1- --- 1 he und=rsigned owner/appl�canl herehy agiees lo hold 0nd sava harm� m <br /> (t'JP� less Ihe Cdy ol Everett trom eny antl all cleima lor dameges, cosis. <br /> - eMpensas, or ceuses of act�on Ihat may arise because of in6tallalion <br /> �� /�`� / -��s and mainlenance of Ihe imp�ovement or other nphl�ol-wey use her^lo <br /> `=��f�� applied �or on. luriher agrees lo remove 68me upon no�ite Irom �he <br /> Approve�Conslru�:�io❑ a�e City and o replace PubGc property damngetl thereby. <br /> �l ir�/.,k,.G--�� �r- � / �%j��� �< �, � <br /> FINAL INSPECTION �a�" . — l �C����yv,V�� <br /> qppwved er+Conat�uctsd �ature o� AnP��cant <br /> WORK AUTHORIZED BY THIS PERMIT 61UST BE STARTED WITHIN <br /> pyp�p(� PUBLIC WORHS DEPhRTMENT 180 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar S�reel BE DILIGENTLV PURSUED �O COMPLETION. THIS PERMIT MAV BE <br /> EvnreU WA 9(i201 CANCELL ED BV THE CITV UPON ANV STOPPAGE OF WORK ON THIS <br /> i Phune 259�8l315 PROJEC7 OVER 90 OAVS DJRATION <br />