Laserfiche WebLink
��,�, �-.ApPI'�catiniForT� POSTINt� <br />�iC:._ FUBLIC �IV06�KS PERMIT <br />�ii <br />PUBLIC-WORKS DEPARTMENT <br />3C00 Cedar SM1eet <br />Everetl,` YJ\ 98201 259-8810 <br />fi <br />!' l <br />TYPE OR PRINT ONLY <br />MARK SELBY <br />Owner <br />CURT .IOHNSON <br />Applicant <br />Describe Proposed Work <br />ppR 1 8 �94� <br />____--- � <br />oate__ 12/11/96 <br />Public Works I�ermit p_��. O I C.i _ <br />Building Pertnit a_ 57739 <br />..J C�� (' C' «i O O ' � <br />J: • �r'. r-- � I'y C i ' f:` <br />i r.. f_i CI cF Q�� <br />� ti1 0. t,-� -¢) l tT <br />� . a.� .. .:i n <br />D'i el <br />2 SPRINGBR�OK RD L1F 51�EWENS a;982� <br />Mailing Addfess �-� �� .-, �—�; Ci{y a— <br />u� �� -t r� r r� r: �.� in <br />�] O �n ]: " r-� �ii C.`� «� c] h� 7 r� <br />O..] U Fi f.] f— Ll _i U) O t:l (�1 <br />4733 ' r� ;�-.„r.i5-r.iw:-n i <br />a� r . �z �m rn ii� :r �._ <br />Mailing Ad ress � � City <br />PROJECTADDRESS(ifknown) (Q�p� <br />Attach lour (4) coples of plans for proposed work - Draw to scale and note ihe following if <br />Pu61ic Works Fee $ _� <br />•Property Lines •Outline and dimensions of all aaisting and proposed structures on the lot •Existing and prcposed utilities <br />'Centerline ol sireet •Indicate North •Show any proposed grading changes •Show measuremenis <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS: <br />1. All cails for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />� l' Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />� Insto-ill an iotiltratirn� irench built �� per tlir rin�,v..ReSid!'11hflI ROOt DOINIS�)011i SVb'iCill' desdail <br />ei. �•d a�s prr th�� city �"l�able ll1-3.2 "Root�llo��nspout Sy�tem Siainq' stsy�led to Q�i� petmit. 'l7ii• <br />intil4 atiuu lrancli ,Lull Le no clo,er tli:ui 5 leet to mrv up slopc prope�ty lina ur ioimdution nor cl� <br />than l0 lcet to ;my dou�nslopc property lin�• or loimclation. Call Public 1Vorl:s for m� inspection p <br />Io cov�rinv, treuches. <br />W` <br />r <br />♦�A <br />V♦ <br />�w <br />_ / <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Th= undzrsigned owner/applicant hereby agrees to hold and save harmless <br />�he Cily ol Everett �rom any and all claims for damaqes, costs, oxpenses, or <br />cc�ses ol actlon that may anse ber,ause oi installation and maintenance ol <br />the improvement or other righFol-way use nereto applied for and fudher agrees <br />to remove same upan notice from Ihe City and to replace public property <br />damaged ihereby. <br />S�g atu IApplicant Date <br />WOfiK AUTHORRED BY TNIS PERMIT MUST BE STARTED WITHIN 1B0 DAYS OF DATE PERM IS ISSUEO AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION THIS PERNIT MAY BE CANCELLED BV THF CITY UPO� ANY STOPPAGE Oh� WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />