Laserfiche WebLink
------�._..r__._ - <br /> � �ete� � � PuElmWarY�Par <br /> , Applleation For BICp D�pl.� _ <br /> PUBUC WORKS PERMIT PJeToI�iee`�• . <br /> � leaApo� FaePuE � <br /> x <br /> � Print or Type Only B�i�nca Due • <br /> � <br /> �� ��i ll). SII�C2_��'l PY� QiFs�� <br /> Owner MalHng Atldress C�ty Z�p Phone <br /> K M <br /> Applicant Meilinp Address Cny Lp Phone <br /> Oescrlbe ProDoeed Work ����L1lr ��� �I <br /> � Pro�ect Addrenn 111 knownl � <br /> a Attech lour(4)coD�ea ol plane lor propaned work• Draw lo scale and note the lollowing as appllceble: � <br /> f� • PropertY Linoe • Centerline ol street � <br /> � • Oulline and tllmennions ol ell e�letinp and • Indicate Norih I <br /> propoaed elructuree on the Io1 • Show eny propoaed Qreding chenpea <br /> k • EKlsting and pioposed utlliNe6 • Show meaeuremente � � <br /> � O N I EL HI LIN O , <br /> PERMIT CONDITIONS <br /> 7./UI ulls fo�inspectlon shall be mede 24 hrs.in edvence•phone 28�881�. <br /> 2.All work�h�ll bs peAormed In accordance with this permlt and current Clty o1 Evereq Desipn end Conetructlon ' ; <br /> Stend�rds�nd 9peclfkatlons , <br /> 3.Cdl Loatlon Underyround Service 4B hra belore you dlp.TOLL FREE NUMSE111•800�424bb6b. � � <br /> �U�,G Gc��y�i-s�.�Z� O <br /> GL��..�0 �o�l.�c� �/� <br /> \// <br /> �'`�9 � 8� a �� <br /> I , , <br /> � <br /> � ACKNOWLEDGEMENTOFCONDITIONS ��, <br /> Tha undersigned owner/applicant hereby agreea lo hotd end seve harm� <br /> � less the City of Everetl Irom eny end all clalms for damaBa& costs. <br /> i <br /> � ezpenses. or cauees ol ectlon Ihat may arlse becauae of Inatallation <br /> { and maintenance ol the improvement or other righl•obway une heieto <br /> epplied lor and lurthe� agrees lo remove same upon nolice Irom Ihe <br /> i ApDroved lor Construclion Oata Clly and to replace public property dameped thereby. <br /> 4 <br />, jFINAL INSPECTION Date SI nalure ol A IicaN � <br /> �. Approved as Conatructed g pp Dale <br /> � WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � everett PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 CeAar Street BE OILIGENTLY PURSUED TO COMPLETION.THIS PEflM1T MAY BE <br /> �i � _verelt,WA 88201 CANCELLED BV THE CITV UPON ANY STOi'PAGE OF WORK ON THIS � <br /> Phone:269•8810 PROJECT OVER 80 DAVS DURAiION. ! <br />