Laserfiche WebLink
r <br /> `• � , � '�,l T.7 I <br /> DefO ,�I Y r„r���w�„w�r��._ �T <br /> ApPlicelion For Flinp oeo� • �_ � �' <br /> PUBLIC WORK� PERMIT �,-�°�°W°,�.��^ - - <br /> lole�f�e s <br /> Laff�901 [ee PUG S _'_.= <br /> Print or Type Only e.�,��so�� s�� __ <br /> � I C�C� I ��� ' cU - . �' � <br /> 0•.oner Mailing Atltlress Crty Lp phone �.�\ <br /> ��L¢�CJ <br /> !,� �. <br /> ` _ <br /> Applicant Mailing Address Gry Zlp P�one � <br /> � � � �� ,(�� <br /> Deacrlhe Froposed WorM _��_��s,�t. �. 1 <br /> _ F'n�L " <br /> -- �1z- � t-�T_.Z��• �� <br /> Project Address(il knownl —�zO-3 �' C-f770�v1 QG.K_. � <br /> � <br /> Attech f0ur(4)co0�as ol plans lor proposed work-Draw to scr�e and note the folla,ving ns anpBcable: � <br /> • Property Linas • CenlerGne �f slreel � <br /> • Oulline end dimensions ol ell eKis�ing nnd • Indicate Norih <br /> proposed struclures on Ihe lot • Show eny proposeA y�radinq changes <br /> • ExistlnB and Groposed ulilitins • Show measu�ements � <br /> DO NOT WRITE BE�OW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All celte lor Inspection ehell be made 24 hre.in edvance•phona 259•8810, � <br /> 2.All worN ahell be peAvmed In eccordance with this permit and current Ciry ol Everett Design and Conotructlon <br /> Slendarda und Spar,llicetlons. <br /> 3.Cail Location UnCe�grnund Sr.rvice 4d hrs.6elore you dig.TOLL FNEE NUMBER 1•800•424•5555. � <br /> O <br /> � <br /> � <br /> O <br /> � <br /> �.U.. ACKNOWL[UGEMCNT OF CONDITIONS <br /> r The unders�gnetl u�.nrriapplicant hereUy,^.g�ees to hold and save harm� <br /> — ---� less Ih� Cdy ol Everelt irom any and all cieims lor dempges. co,ts, <br /> � /J CMpCfi3P.5, Of causes ol aclion Ih�t mny a��se because ol mslallalion <br /> f�L_� � �G�� end maintonance ol ihe improvemenl oi other nyh; ol�way use he�elo <br /> .C/!� �p/Ol>2 / <br /> s ep d inr and iwther ngree; lo remove swme upon nolice hom Ihe <br /> App�ovo�ructior( ��7 Dale G y��d to replace ,ubhc properry d ageA thereb <br /> �/ � <br /> ,i [ r!.i:".� .%'-1 Y-d�' � n�[ <br /> FINAL INSPECTION Date � ���`� ° � <br /> Approved ns Constructed S nature ol AnPhc - ate <br /> everen FUBLIC WORKSDEPARTMENT WORK AUTHCRIZGD BY iHIS PERMIT b'VST BE STARTED WITHIN <br /> � 370ui.stlar5�ree! 1B0 DAV� OF DATF PERMIT 19 ISSUEI� AND THEPEAFiCR IS TO <br /> E.+relt.WA9B201 BE DILIG[NTLV PURSUED TG f,OMPLETION. TH�: PERMIT MAY BE <br /> Phone 25b HB10 CANC[LL[D BV iHE CIiV UPOP! ANV STOPPAGE Or�JORK ON THIS <br /> PROJFCT OVER 90 DAVS DUF�TIO" <br />