Laserfiche WebLink
� <br /> r � <br /> PubimWorbParmi�• "'�1s�fG� <br /> Date���� � <br /> niaa Deoi �- <br /> ppplicetlon For <br /> PUBUC WORKS PERMIT ��` 'S�� PueucWo�w�Fae � <br /> .o,.��.. • <br /> � lau Apo� fes PUE �.�—�-pr <br /> �/�./ ' <br /> 8����ce Oue S <br /> Print or Type Only <br /> � � � -�nJaS�'�`^� —�-���..a <br /> Owner <br /> Melling Address City 2ip Phone <br /> Co � �w�:.e `? .o. �o�C �zq9 E� ►�--� �Josh �se-3�.v-1 <br /> ��m nc 1' �n _ <br /> qpplicant Meiling Atldrese �i�Y ZiP P�'a�e <br /> �o" w�r �•r <br /> Daecribe Propoaed Work � 4"� <br /> W <br /> Pro�ecl Add�ese(il known� <br /> � � -� . c..,s��... a- � <br /> � <br /> Altech four(4) copiee ol plena lor propoaed work- Draw to ecele end note the lollowing as epplicable�. � <br /> • Property Llnee • Centerline of sireet <br /> � Oulline and dlmaneione ol ell axialing end • Indiceta No�th <br /> proFosed atructurea on the lot • Show eny proposed g�admg changes <br /> � Ezisling and Dropoeed ullllliea • Show measuremenls M <br /> W <br /> DO NOT WRIiE BELOW THIS LINE O <br /> PEfiMIT CONOITIONS � <br /> 1. All calls inr InaDectlon ahall be mede 24 hre. in edvence-phone 259•B81 5. <br /> 2. All work ahell be per�ormed In ecco�dence with ihis perml�and current City ol Evnretl Desiyn end Conslruction <br /> Stenderda and Specilicetlona. � <br /> 3. Cell Locetlon Underground Service 48 hra.before you dig.TOLL FREE NUMBER 1•800•424•5555. <br /> /� �.�y C- pO �'Oy.G.d �/nS Q R T�—� �CJ///C�Y� O <br /> " " � / <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLED(iEMENT OF CONDITIONS <br /> The unders�9ned owneUaPphcant he�eby egrees to hald end seve herm� <br /> Iess Ihe Cily ol Everett Irom any nnd all cleims for dameges, costs. <br /> eMpenses. or ceuses ot aclion ihet may a�ise because ol instelletion <br /> end mnmtenance ol Ihe improvement or other righbobwey use herelo <br /> epphed lo� and Iwther ag�ees to remove seme upon notice Irom Ihe � <br /> Approved r C siruction Dale Cily nnd to replace publ�c nroperty damaged �hereby. <br /> ` ��¢� �—`��"'-� \o-3�B4 <br /> FINAL INSPECTION �B�e Dete <br /> Approved es Construdetl Signeture of Applicant <br /> WORK AUTHORIZED 8V THIS F'ERMIT MUST BE STARTED WITHIN <br /> everetl PUBLIC WORKS DEPA ENT 180 DAYS OF DATE PERMIi IS ISSUEJ ANO THEFEAFTER IS TO <br /> � 3200 Cedar Slreel BE DIIIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> Everett.WA 98201 I i,ANCELLED BV TNE CITV UPON ANY STOPPAGE OF WORK ON THIS �J <br /> Phone: 259�8�15 PROJECT OVER 90 DAVS DURATION. <br /> i " <br />