Laserfiche WebLink
�ly I <br /> �et@ " � PuEllc Warb P II• ��_ �" � <br /> Applicaflon For BICp De01.• ls .3 � <br /> PUBLIC WORKS PERMIT Pu�Tol�FeeFea s — <br /> Leu ApOI Fee P�IE S <br /> Pfinf Of TypO Only e.�.��,n�, s�4C� <br />� - <br /> --� 79Ys'/ <br />�; ��-.-,,;��.�L'�� 903/ —.3�'r�'`S� �� ��_ 3� � � <br />,� Owner MelNng Address City Zip Phone <br /> �'.��� C��� <br /> Applicant � Mailinp Atldress Gry Zip Phone <br /> Deecrlbe Proposec Work -I ��[ <br /> W <br /> Prolect Addrees(il known) � <br /> Atlach lour(4)coplea of plans lo�proposed work•Draw to scale�md note the following as eppliceble: � <br /> • Property Linea • Centorllne of etreet � <br /> • Outllne end dimenalona ol ell eziating end • Indicate Nohh <br /> propoaed et�ucturea on the lot • Show any p�op�sed gredlnE chanpes <br /> • Ezlsting and propoeed utllilies • Show measurementa � <br /> DO NOT WNITE DELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1. All calls lor inepectlon ahall be mede 24 hra in advanca• phone 259•8815. � <br /> 2. All work ehell be perlormed In accordance with thle permll end cwrent City of Evarett Design and Conatructlon <br /> Standerde end Speclllcatlons <br /> 3. Call Location Underpround Servica 4B hra.befoie you dlg.TOLL FREE NUMBER 1-800-424•5555. � <br /> y QG�'LiC�•uT To .p.QOai� �,Pl�,��1atiGE 6Ue.�,vr�' O <br /> � ST,���r �,� Ac�Ey r�,�,��„E,,,�tiTs �,�:�moa� <br /> s,T�- <br /> .'j !lJO.�y.E- To BE �+�+�E F�,e Ao,a,:zov�,o p;A� <br /> lL4f�'O 8- 26-�'.S" �I/ <br /> O <br /> �P JJJ <br /> ,.�,.� a <br /> � � � <br /> // �� `��� � <br /> � � ACKNOWLED�FMENTOFCONDITIONS <br /> The unde�signe ownei/epplicent hereby eprees to hold end eave harm� <br /> less thrt Cily Everetl Irom y and all cleims lor damoges, coste, <br /> � expenses, or euses ol ucti thet may arlae becauae ol installetlon <br /> �� and mainto nce oi the i r vement or ather right-ol-wey use hereto <br /> Approved lor� truclion epplied fo� nd lurthcr a s t emove eame upon nolice I�om the <br /> � 1e Clty end �eplacr pu61 ope damaged Ihereby. <br /> FINAL INSPECT!CN p��e — � '4 � <br /> Approved es Constructed SI ature ol Ap licent Date <br /> everett PUBLIC WORKS DEPAHTMENT V:'1fiK AUTHO 12ED BY THIS PERMIT MUST BE STARTED WIiliIN <br /> � 3200 Ceder Street 1B0 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER I;� TO <br /> Everett,WA BB201 BE DILIGENTLV PURSUED TO C'�MPLETION. THIS PERMIT MAY B[ <br /> Phona:259-8815 CANCELLED BY THE CITY I�pON:NY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />