Laserfiche WebLink
�8�e�[-�✓ PUDI1cWarM�Parmll• �S�d�S <br /> Appllc&�lon For Biep Deo�-• <br /> PUBLIC WORKS PERMIT P°°��W°�.F.. <br /> Tob�F�a � <br /> Leu�ppl Fea P�Id � <br /> Bannce Oue • �0•�� <br /> Print or Type Only <br /> �rD 9�' L�0• . ��-/�`lh�t S./v. ��/2i'P.ff, 98r;1� ..�9-7//�� <br /> Owner � Mailing Address II� 2ip Phone <br /> o��9MC <br /> Applicant Mailing Addresa City Zip Phone <br /> Deecrlbe Propoeed Work 1�i�L�SLL �"�/l✓� �n�� � ��l(J <br /> �Sfl'D!f" fQ .S'Dd7`f) /YGi�)f `i/�/,/ //l.L . � <br /> w <br /> Prolact Addraea(If known) � � � <br /> Attflch lour(4)coplae ol plene for p�oposed work• Draw to scele and note the lollowing es appliceble: � <br /> • Property Llnes • Cenlerline ol sireet � <br /> • Outllne end dimeneione of all exleting end • Indicate Norih <br /> propoaed etruC�urea on the lot • $how any p�opased gredinp chxngea <br /> • Exletinq end proposed utilllles • Show meesurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PFRMIT CONDITIONS <br /> 1. All cells lor inepectlon ehell ba mede 24 hra In advence• phone 259•881 5. � <br /> 2. All work ahall be perlormed In ecco�dence with this permit and cwrent Ciry of Everett Design and Conatructlon <br /> Slandarde end Speclflcetlona <br /> 3. Cell Locallon Underground Service 48 hra. before you dig.TOLL FREE NUMBER 1•BOO•424•55$5. � <br /> `/, Md N�YOLE Tn BF lp,vsrk vcTF� GE.c� O <br /> C�Ty Sra�vaa,¢o �'605 w,r:r n-se,v.ro�E <br /> .Qi,r/6 � C'Ol�FiE PE•e STaNUD�'p f� (o07liPE✓.SED �S, <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENi OF CONDITIONS <br /> The unaersigned owner/npplicent hereby agrees to hold end save harm� <br /> less Ihe City of Evere�t iram any and ell clalma lor damepea, cost& <br /> `'-J�y� �bs� ��- P%penses. or ceuses ol ection Ihat mey erise beceuse ol Insta�lellon <br /> and mnintenence ol Ihe Imprcvemenl or other righ4ol-wey use hereto <br /> epplied lor end lurlher aB�ees lo �emove seme upon notice Irom ihe <br /> Apprmed lor C nsiruc�ion� ale Cily nnd to replace public property demeged thereby. <br /> ����� /� / <br /> �I�t�[-- , '-{-.�// f( <br /> FINAL INSPECTION Date � ' [ ,� - ���� � �/�E� L'� <br /> Approved ae Constructed Signature ol App ican � Date <br /> everetl PUBLIC WORKS DEPAftTMENT WORK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200 Cec�er Slreel 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everelt,WA 98201 BE DIUGENTLY PURSUED TO COMPLETION. TNIS PEFMIT MAV BE <br /> Phone: 259-8015 CANCELL[D 6V�4E CITV UPON ANv STOPPAGE OF WORK ON TNIS <br /> PROJECT OVER 90 DAYS DURA710N. <br />