Laserfiche WebLink
�AfR�� PpMic Worb Permil� �_�1 _/�� _ <br /> Applltelion For Biey Deo�.• �/ � 7�S.sSS� <br /> PUBLIC W�URKS P�RMET °°°�kW°,�.F°. --- <br /> ,o�.��.. •-- <br /> �...�oo�v•nna ! <br /> B�hncs Du� � <br /> Print or Type Only — <br /> �. ,�,,,��� na,�p(��,�,e,�� �n9 E (`aNNn �s�,,�, �. ��a,ar� 9�ri36 ����� <br /> Owner T— Meiling Address Cit�� Zip Phone <br /> �Omm.1�4t�n�.�A�i��.q�a�u�aaae g���l� . �GU L�lL�tw�c� liL/�' �d/'-S Phon77/�Z3011 <br /> Oppicant <br /> Deecribe Propoeed Work �P s�n n 1� �rv� DT lri�/(! Wl ��/c,g �0 /Lt��___ <br /> . � <br /> - /� ,, �, W <br /> Pro�ect Addrose(A known) _. ��� F �tr.f�itQ' K J Su i � � <br /> Atlech fuur(4)copies of pfana for proposed worN•Draw lo scele end note Ihe lollowing as epplicahle: � <br /> • Property Llnee • Centerline ol slreel � <br /> • Oulline end dimenaiona of all exist;ng and • Indicate North <br /> propOeed strucluree on Ihe lol • Show eny proposa�i predinp chenges <br /> • Exleting end prupoaed utilities • Show measurementa � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIUNS <br /> 7. All calls for inapectlon shell be mede 24 hra. in edvance-phone 259•8b15. � <br /> 2. All work ehell bo pertormed In accordence with Ihis permit and currenl City af Everelt Design end Construction <br /> SlandarCs nnd Speclfications. <br /> 9. Call Locallon Undarground Service 48 hrs bolo�e you dig, TOLL FHEE NUMBEH 1•800•424-55Cl5. � <br /> /l� �u���� L+�o,�ts f'E,c��-a-T ,f'E-o��,r.�✓> io O <br /> ��g� <br /> �� � <br /> � <br /> OA <br /> �a <br /> ACKNOWLEDGEMFNT OF CONGITIONS <br /> The undersigned owner/applicant hereby agrees to hold end save ha�m- <br /> — — less Ihe Cily of Everett Irem any end all claimr lor oema.7es. cosis. <br /> expensos, or ceuses ol ac6on Ihat may nriae Cacause ol installation <br /> and mqintenence ol the improvemant o� other nghbol�wey use hore�o <br /> epplied lor nnd further agrees lo remove eame up�n nolir.� Irom Ihe <br /> ApProved for Cor�siruction Date City end to rxp�ace public property dame�ed ihereby. <br /> FINAL INSPECTION Date - <br /> Approved as Constructed Signeture al Applicant Dnte <br /> evercll HUEUC WORKS DEPARTMENT WORK AUTHORIZED BY fHIS PERMIT MU57 BE STARTED WITHIN <br /> � 320!)Cedar S�reel 780 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Eve�utl,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BF <br /> Phcne: 259�8015 CANCELLED BV THE CITY UPON ANV STOPPAG[OF WORK ON THIS <br /> PROJECT OVER 90 DAVS DURATIbN <br />