Laserfiche WebLink
o9e s-9i .�,��W�..�.��. Yz Z .� <br /> Applleatlon For eua o.p . <br /> PUBLIC VIiORKS PERMIT �°�W�^��� <br /> ra.i r« • <br /> T� �QSTING FEB U 5 7.001 `°'•�°°"••°'" • — <br /> Print or Type Only ' � e�uM•o�. t <br /> T �A B��E�� � <br /> ��ori�.� c'o, �c�, G4oA' .��07 /y�/S oF-76 �'Pa�P�y_ Cc�n_ 79/2S�Q/G7 .�YZ- 587B <br /> pwr(er Mu�NnO AOdrass City 21p Phone <br /> Len .1, 1G6 - jSN.j <br /> J�qme <br /> Applicant Mellinp Addrese City Zlp PAone <br /> Deacribe Proposed Work Co� t f'r�c f' ��'C�t ft?C� �vt flon d /h /a0(.ucrE'r' _ <br /> h�iL( Gc�lc/i - Nnr�h of�etcnfior� �pono� �7h[/ J'Oc�t�i o� <br /> .ff� ✓� L <br /> . W <br /> Prclect Addresepl known) �n0�' - �L! � Sinn � � <br /> Atlech lour(4)copiea ol plans lor propoeed work• D�aw to ecsle and note the lollowinp ea apr.��:eble: � <br /> • PropaAy Llnes � Centerline ol street � <br /> • O�Iline and dlmanslone of all exlstinp end • Indlcete Nohh <br /> proposed etr��ct�rea on Ihe lot • Show eny propoeed pradlnp chanpea <br /> • Erieting end proposnd utllitlee • Show meaeuremenle � <br /> DO NO WRITE EL W TI11S LINE O <br /> PERMIT CONDITIONS <br /> 1.All calle lo�Inepectlon ehell be made 24 hro.In advence•phone 260�9410. � <br /> 2.All work ehall be peAormed In accordance wlth thls permlt end current Clty ol Everott Deelpn and Conetrudlon <br /> Standerde end 3peciflcatlone. <br /> 3.Call Locatlon UntlerprounG Service 48 hrs.oafore you dlp.TOLL PIIEE NUM�E111-a00�4Z46b6b. � <br /> y l�io.�,r ro � Do.�/E f�k A��,en�,�o ,�.v,✓.r GUrf.O y-��L � <br /> S. lUt�/�- /N TiYE ��r'le/� f.7�jll To BE 1.��NE AfY[4' � <br /> Y <br /> .7i.vVE �_�,� f3'�^ 6i1y 0� E✓�rc7Yl SeasonuL �/.��fntioh <br /> /L'g C9�.:liJ�: n�"I 4n!/ �e:�' CGS. /���fi,94tinn , � <br /> A �i.vo NEf�ct' O <br /> t�l S.F.'i. �S�' <br /> � <br /> ACKNOWLED6EMENT OF CONDITIONS <br /> The undereiynad owner/aDPlicant hereby apreee to hold and eeve harm• <br /> leee the Clly ol Everett Irom any and all clsims lor dameqee, coeta <br /> -, eMpennes, or ceusee al actlon thet mey arise becauee ol Instelletion <br /> end maintenance ol Ihe improvement or other riphhol•wa/uae he�eto <br /> { eDP�led for end lurthar epreee to remove eame upon nollce Irom the <br /> Approv o Coyt uc Dete Glty and lo replace pu Ic property damaped thareby. <br /> i � /� / <br /> FI L INSPECTION '" � � ��� �'��"!�'� � ]�/i Z <br /> App�oved ee Conetructed Signat ol Appllcant Dete <br /> � PUBLIC WORK3 DEPAFTMENT �MORK AUTHORIZED BY TNIS PERMIT MU9T BE STARTED WITHIN <br /> 3200Cedar8lrest 180 DAVS OF DATE PERMIT IS ISSUEO AND THEREAFTEH IS TO <br /> Everolt,WA98201 BE DILI�ENTLV AURSUED TO COMPLETION.TH19 PEqMIT MAV BE <br /> Phone:26&8810 CANCELLED BY THE CITY UPON ANY 8TOPPAOE OF WORK ON THIS <br /> PROJECT OVEq 90 DAVS OURATION. <br />