Laserfiche WebLink
oe«�-�� � ., w....�.y�yy����� <br /> APPhcaLen for O�ny u•a . 1„1-J . <br /> PUgLIC WORKS PERMIT °•°;ow°r::'� f. - <br /> «...o�:�..�.a • _— <br /> e..�.��. s <br /> Print or Type Only <br /> }�'F�S �1��1�i1'�`�� `.�—L� 1')4D(L�41� YF�, ��J _ <br /> Ownei Madmg Ftlaress C�y 2ip P�one <br /> � L� <br /> ApPhcant MaiLng Atltlress GIY Zi0 Phone <br /> Drscr�be Proposed Work �, +�.�� `-�' ��+Y' ^ - <br /> -- - - W <br /> Prniact AaCress UI knownl �L -+--�—��'�/ � <br /> 1 <br /> A118C�IOo�141 COV�pS OI PIHn510�p�OpOSPG wO+F�D�dw to 5f.alc dn0 nOIC�hC IOIWwiclJ d5 TppLCdbIP�. � <br /> •Praperry L��es •Genler� �ol 6ireel �A <br /> •Outnne a�d e�mensio�s o�ali e.ahng and • Indicatc North V� <br /> pr000sea s�mclures o�I�e Irn •S�ow any proposed graGing c.�anpes <br /> •E��siing and pronosed ulJibes • SM1ow measuremenis � <br /> DO NOT WRITE BELOW iH15 LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls�or inspeclion s�all be mede 24 hr6.in edva��ce�phone 259•8870. � <br /> 2.All work shnll be pedormetl in eccortlance with ihis permit nnE cunent City ol Everetl�esign ertd Consimction <br /> Slantlartls anE Specificalions <br /> 9.Cnll Location UnEergmunE Service 40 hrs.belore you d�g TOLL FREE NUMBER 1•800�424•5555. � <br /> 110T I�C� `�:l�r„/� � <br /> 7—S/-S9 � <br /> VI <br /> O <br /> , <br /> a <br /> A�KNOWIEDGEMENT OF CON�ITIONS <br /> '� The untleis�gne7 ownP9 app��canl hciel',y agrees to�ola anC xave harm� <br /> IP55 �hP. Ci�y nl Everel� Imm xny ane a1l aai�ns lor aamp�es. cosls. <br /> �;epensM. oi ceases ol aclion Ihat may arise because of �I15�dIIT110� <br /> �� I antl mainlenance ol�he impmv?ment or Olhei ngnPol�wey ust��erMo i <br /> aOPlir.4 lor and lurtnei agrees lo remove aeme upon nob�e hom the <br /> pmved�o�ConsVuction Oate ���y and to repiace O�Obc property Axmaged thereby. <br /> 4AL INSPECTION Dale — <br /> pmvee as Conetm�ted Sipnatwe of ApO��cant ���e <br /> WORN FUTHOF2E0 BV TMIS °CF UIT MUST BE STAflT[D N9TMIN <br /> 'pvem�t PUBLICWORKSDEPAFTMENT 1B0 DAVS OF D�TE PLRMIT 13 RlSUED PND TY.EPEAFTER IS TO <br /> � 3200Ceaer51ree1 gE �ILIGENTLV Pl1RSUED TO COtIFLETION.THIS PERMIT MAV BE �� <br /> [vrrrlt W.�99201 CANC[LLC�AV THE pTV UPON AI,V$TOPP�,E OF WORH ON i1Ug <br /> PM1one�25'-881� pROJEGT OVER 90 DAYS DURATIOti <br />