Laserfiche WebLink
Hn� <br />O�H <br />HZ� <br />�Ha� <br />�f i�i �1 <br />NM <br />� O � <br />ON <br />�/��8 <br />y�Y � <br />t"y� <br />gyy <br />�d� <br />��� <br />HOtn <br />1 � � <br />; L �I <br />I <br />! � � <br />: , <br />- <br />r--._,.. <br />i <br />� <br />� �ate_g�q,y�$0 Y t <br />�' Applreation For <br />; PUBLIC WORKS PERMIT <br />Print or Type Only <br />� �� I Ci�LI�� WnrYs i9�mi1 • _ == <br />omq o.oi • ���5�51 <br />Puei¢wo�blee s <br />Toi.iree <br />i xs. enni �e« va�n S <br />naia„�.O�n S <br />i <br />Ipen Leelie 7006 Herkehire Dz. Everett 90203 353-2611 <br />� Owner MadiagAtld�ess Ciry 7.ip Phone <br />Mailmg Adtlress <br />Zip Phone <br />Describe Propo�c9 �':o�k �41tio71 t0 3FR -- <br />Projec� Adtliess lif knownl — <br />At�ach four (4) copies ot plans lor proposed work � Draw lo scalo antl note Ihe lollowiny as applicablc <br />• Prope�ty Lines • Cenlerhne of slreet <br />• Outhne and dimensions ol all ezistlny and • Intliwte Norlh <br />pwposetl s�ru:lures on Ihe lol • Show any p�oposed UraAm9 changes <br />. • EMisting antl p�oposed utilities • Show meas�:emenl5 <br />PERMIT CONDITIONS <br />1. All cells for inspeclion shall be made 24 hrs. in advance � phone 259•8810 <br />2. A'I work shell bn pedormed in occordance wilh ihis permil and cunent City ol Everett Design and ConStruclion <br />Standards and :ipecilications. <br />3. Call Location Undergmund Service 48 hrs. belore you dig TOIL PREE NUMBER 1•800•424•5555. <br />N. �—. �_l._iL ��y�c �L���_ �L�.J-��T" ��i::: _, �.-s li <br />� t � i „ � I �� l_�.�.... <br />Approved lor Construction Dale <br />FINAL INSPECTION �0�e <br />Approved as Consirucled <br />rvr�rn FUBLICWORKSDEPARTMENT <br />� 3200 Cedar Street <br />Everetl, WA 98201 <br />phono'.259-8810 <br />. �' <br />ACKNGWLEDGEMEN70FCONDITIONS �� <br />The undr�si9netl owner/apPlicant hmehy a9rees to hold and save harm� <br />less Ihe City ol EverMl Irom any and all claims loi damn9es. costs. <br />eapenses. or cauces ol nclion thal may arise because ol installatlon <br />anA main�enance, ol Ihr, improvemenl or other ng�Pobw2y use hereln <br />�pplied loi and Imther ayrees lo remove same upon notice Irom the <br />Cdy lnA �o rrplaCC pu61iC pfoperly d�ma9eA Ihereby. <br />Siyn�lwc ol Apnl�r.ant Date <br />WORK AU7HORIZED f3V 7HIS PERMIT MUST B[ SIARTED WITHIN <br />180 DAVS OF �ATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSU[D TO COMPL[1�ION THIS PERMIT MAY BC <br />CANCELLE� BV THE CITV UPON ANV STOPPA�L OF WO�K ON iHl:; <br />PROJECT OVER 90 DAVS DURAiION <br />