Laserfiche WebLink
�_ -t <br /> �BtQ ���� PUE��c Work�Permll� �Y/.� <br /> Applicatlon For eiea oeo��• <br /> PUBLIC WORKS PERMIT PuUucWarw�Fea .� <br /> Tot�l Fse s <br /> Leu�OOI Fee I`uE � ���_ <br /> B�I�nc��u1 f <br /> Print or Type Only <br /> JI'cc• .�- E��o27 <br />� ' <br /> �'IZ_ � sT�lzt. Cb�1s ilzlu.�aU 95 y' �v� a,cx�`�1�BL-ZL -v vt;G�4 �h8o�4 <br /> ownar Mellinp Adtliasa cuy zip rnone 455 �S7(7 <br /> A�d�1 E �v�� 2�os UicioR 1�L ��.�-�- q �� I as�� 3c�s _ <br /> Appllcant MeltingAddrese City Z�yoR.N �'�e - 'S S S• 7o"!O <br /> Describe Pro��oaed Work T � �-� LC7—r �-b O n C y � !M d L'�'-/ � _ <br /> /S�'3c o �'c.- ✓A. 'E�]' ��J /Id�iT��n� 7a .sao�yi9�.eu� <br /> �nJ f�.C'/!>,�T �.r'-/��.5 <br /> ��2n5c . I (� W <br /> Pro�ect Addreea pl known) � �`�7-' �N �,QS / /��U ,�U'v�.V . � <br /> Attach�ow(4)coplae ol plens lor propoaed worh� Draw to scale end note Ihe following as applicable: � <br /> • Properly Linea • Cantedine ol street � <br /> � Outllna entl dimanelona ol all exiatinp and • Indicele North <br /> i propoeed el�uctures on the lol • Show xny proposetl grading chenges <br /> • [xietlnp end propoaed ulllitiee • Show measurementa � <br />� DO NOT WRITE BEIOW THIS LINE O <br /> PERMIT CONDITION5 <br /> 1. All calle lor Inapactlon ehell be made 24 h�e. in advence- phone 258•881 5. � <br /> 2. All work ahell be perlormed In accordence with this Aermit end current City ol Everett Design antl Conslruction <br /> Standerda end Speclflcatlona <br /> 3. Cell Locetion Underpround Servlce�4A hre. belore you dlp.TOLL FREE NUMBER 1•800•424•5555. � <br /> y, ,� ���,�v�� ��,��� �o��� /--�6�y O <br /> S:=f�} �Y3��, � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The underelgned owne�/e4P�icent hereby agreea to hold and save harm• <br /> leas the Gry oi Everett Oom eny end all cleime lor damupes, coata <br /> �� � ezpense8, of ceuses ol eCtlon thel mey eriee beGeuae ol Inetelleli0n <br /> //L 4DU end maln�enence ol tha improvemen� or olher ripht-o�-wey uee hereto <br /> N � applied lor end Iwther agraes to remove seme upon notice Irom the <br /> A oved for Co ructi De e City end to replece public roper deme Ihereby. <br /> 1 <br /> � -�-� % �,�- /��-s� � /_ �G -d' <br /> !=1NAL INSP ION Dele <br /> Approved e ona�ructed Signature ol Applica 1 Dete <br /> ev� PUBLIC WORKS DFPARTMENT WORK AUTHORIZED BV THIS PERMIT MUST BE STARTED W�THIN <br /> 3200 Cedhr Streo� 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEH IS TO <br /> Everett,WA 98201 BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone.254��.815 CANCELLED BY THE CITV UPON ANY STOPPA6E OF WORK ON THIS <br /> �� PROJECT OVER 90 DAYS DURATION. <br />