Laserfiche WebLink
,h'r � . . ,n. ,.aw . jl��"�''r%.`"L'.s�7,���'�" '�'ri^7T'^�T(i�" ."n.d.,.. ,.'�+YY/d�{y��L �� <br /> F� /� �y) ,_,� �+ �„� _ �' <br /> Date— "7� I " ' ��,�,���wo,�.o�,m���_Y � ��- <br /> ���• Applicalion For ema o�n� • —:1 � <br /> PUBLIC WQRKS WERMIT ���im�Fee,ee s= <br /> lmaAna� rn�P•m S <br /> C�/ <br /> eaun�e ou. L .i'll.� <br /> Print or Type Only <br /> C�1C�� l���l'�'-���►��� -'���.'� � ' ► r: �i� � t�( � �.�_�x�� ���1�� <br /> Dwner Mading Atldre�s Cny Zip Phor.e <br /> C�)�At � Pn��X Y f" � IT�dress � Ci �_.J l__I P ^ P( �}3�7��� <br /> / / ,� ����-!1/._�.tT <br /> DeeCnbe PropOsed Work � ��J�v����� <br /> .� .,-L '�'��7 � �� ;7� W <br /> Prolecl AtlCresa lif knownl "��� � � ��ly-l1-�— — � <br /> Alfach tour 14)copies ol plans lur proposad work- piaw to swle antl note Ihe following as apP��cable�. � <br /> • Property Lines • Centerline of streel � <br /> • Oulline end dimensions ol ell existing and • Indicete North <br /> proposetl struclures on the�ol • Shuw dny proposed greding changes <br /> • Ezistinp and pioposed utilities • Show measuramenis � <br /> DO NOT WR�TEEELOW THIS LINE O � <br /> PERMIT CONDiTI0N5 <br /> 1.All calia for Inspectlon shall be mede 24 hrs.In advance•phone 2541•8810. � ,I <br /> 2.All work ehall ba pedormad In occrndance with Ihla permit and wrrent City ol Everatt Doelyn end Conetructlon <br /> Slendarde end Specificalinns I <br /> 3.Ca�l Laetlon UnderproucJ Service 48 hra.betore you dig.TOLL FREE NUMBER 1•B00•424•5555. � ' <br /> 7. �✓/dST<. N� 7.%n/!/ (Jf T/>i1 �.Si:i .lJc: _F /[//CL .<EQU/iE O <br /> T� �xiSri,rils SiDE .SE�,�E.�: j� BE ,{�c�fF.'rFo �.•�iTi� � <br /> �.� Af�i'�'('✓ED /l�f�TE��AG Fi �/N�� Th',E BU/LOi+�( � <br /> diC' Tff/�' Tfi�� .S_F/!/_F/� � �i� .�o!!TEO ll•f'iJ(/Nn i✓/_-A/ <br /> dc ���v;�✓,r, O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ! Thc undersigned owner/npPhcant hereby ngrees lo hold and seve harm- <br /> less the City ol Everelt Irom any and ,II claims lo� damagas, costs. <br /> . , / , , / � ezpenses. or cause: ol action Ihat may arise becauae ol instnllation <br /> '� ^ .' :� r� '7'-�-� �� I/ � h�' nnd mamtenance ol Iht imprevemCn� o� o1h0r righbObwey u9e he�B�O <br /> applled for and lurthe� arees to ramove same upun nMice Irom Ihe <br /> Approved lor C onsl ction Date City and to replace it�lr�propsrt rfdamaged Ihereby. <br /> i � <br /> / ( <br /> FIIJAL INSPECTION Dale � '- � <br /> Approver ea Construded . ur. � pphcant �� <br /> � � OR �THORIZED BV THIS PERMIT MUST BE STARTED WITHIN <br /> everelt PUBLICWORKSDEPARTMENT 18dGAVS OF DATE PERMIT IS ISSUED A�JD THEREAFTER IS TO <br /> � 3200CedarS�reat BE DILI�iENTLY PURSUED TO COMPLETION. THIS P[RMIT MA1' BE <br /> Everett.WA BB201 CAtJCeLIED BV THE CITY UPON ANV S70PPAGE Of V/ORK ON THIS <br /> Phone:259�8810 ppOJECT OVER 90 DAVS DUFATION. <br />