Laserfiche WebLink
- . CLEARING, GRUBBING, GRADING, AND EXCAVATION PERMIT <br /> / <br /> Type o�print clearly in ink � ' �'�'l,'I ( '� �� i <br /> PRESS HARD -Y011 ARE MAKING COPIES I <br /> I <br /> i� <br /> Public Wurks ; <br /> � ' <br /> Everett, Washi igton PERMIT N0.��7D -_._:...__ <br /> APPLICANT(Undersigned�AND FIRM REPRESENTED, IF:qNY:_ � '�� I � �� � ' ��� <br /> HEREBY APPLIES FOR PERMISSION TO UAentify(]uantities)_ � <br /> FOR <br /> 7FFICE ATTHEFOLLOWINGLOCATION �SI- 7�� �� �/�a 'no <br /> USE <br /> ONLY <br /> DETAILED,SCALED DRAWING OF WORK TO 8E DONE,ATTqCH 4 COFIES <br /> ATTACH LEGAL DESCRIPTIONS <br /> PEqMIT IS VALID FOR 120 DAYS � <br /> (May be extended upnn written approval trom Public Works) � I� <br /> i� <br /> 1 <br /> A NEW PEqM1T IS RE�UIRED IF WORK �� � <br /> HAS NOT BEGUN WITHIN 60 DAYS �� ��I <br /> TH�S PERMIT TO BE POSTED ON JOB SITE. ��/, ` <br /> '3� <br /> CALL FOR INSPECTION 259�8011 <br /> 24 HOURS BEFORE BEGINNING OPERATION <br /> The undersigned uwner hereby agrees to hold and <br /> save harmless thu City of Eve�ett from any and all <br /> claims for damages,costs,expenses,or causes of <br /> ac�ion that mey arise because ot the clearing, <br /> grubbing, grading,and/or excavation activities <br /> PLANNING/SEPA APPROVAL hercro epplied for and further agrees to comply <br /> with all provisions of this pe�mit. <br /> SignaWre of Appl�cant/Date o(Application <br /> Atltlress <br /> � q���,���� <br /> Approved tor nstr ction ( W) � � <br /> C�IV Zip <br /> Issued (Bldg. Dept) . � Date Telephone Number Altemate <br /> --� ,����..� <br /> r. � <br /> if.'pproved as Consiructed (PW) I�EE <br />