Laserfiche WebLink
� <br /> y (] M <br /> r <br /> di � <br /> y w � 17 16 91 � . • r•,e.,., w�,�.n��m�i• . '___—__—_—_ <br /> . <br /> N DaIP__L_l <br /> ii � 1�c u�.n� o.n� . �1/35076_._.---.. <br /> Annl�cntion Pur <br /> o � � PUBUC WORKS PERMIT °°;�;�,a�„�•° �-- --- <br /> � y ~ lrseenn� InnPun S <br /> a �� o.m„�.o��. 6 <br /> Print or Type Onty <br /> N W <br /> MpE , <br /> y .�"j pvu,L_y7t,{r�lat fi�;3 ^a *� Aua Evesatt 9AZ03 355-6792 <br /> t" M Owner Mailin9 Address Gry Zlp Phonc <br /> N <br /> M <br /> O N Ow[IBL '— <br /> �r� � Apolioant Mailing Address Cdy Zip Phonc <br /> p N <br /> DescribeProposed Work _�71C�ose oQrch �gtall h,athrnnm �SFR) <br /> W <br /> Pmlect P.tldress lil knownl Z601 CheStnUt St. _ __ � <br /> Allech lour(4)copies ol plans lor proposed work- Draw lo sr.aln antl nole Ihe I011owinB ns ap��licnble � <br /> • Propxrty Lines • Centerhne ol slreet ♦^ <br /> • Outline and dimensions ol all eristing and • Indicale North V� <br /> propoSeA StruCtureS on ihe lot • Show any propoSeA qrading chanpes i <br /> �_. . • Exisling and p�oposed utili�ies • Show mensuremenls � I <br /> \ <br /> C� DO NOT WRITE BFLOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection shall be made 24 hrs.in ndvance•phone 259•8810. <br /> 1 —� � 2.All work shall bx peAormed In nccordnnce with Ihis permi�nnA cwrenl Cily ol[verell Design nnA ConstmGion � <br /> i � Slantlerds end SFecillcations. <br /> L� 3.Cnll Location Underground Sarvica 48 hrs befo�e you dig TOLL FREE NUMBER 1•BOO•424•5555. � <br /> , r . <br /> � - 0 <br /> I <br /> � , � <br /> ��� c��- ���,,:.12��' �� �«,z-� <br /> f <br /> � <br /> � ���� �� � <br /> ` !1_i . a <br /> � � - <br /> _ ACHNOWL EDGF.MENT Of COND1710N5 <br /> � <br /> The untlersynoA owneriapplicant hrirby e9ieesto holA and snvr h.�rnr <br /> Iess Ihe CAy ol [veretl lrom any anA nll clmms lor dama�es, cosls <br /> eypenses, or cnuses ol aclion Ihnl may arlse bec�use ol installalion <br /> nnA ma�nlnnnnr,e ol Ihe improvemenl or other nqh4ol�way usc herclo <br /> applieA lor ,nd hniher aqrees te removr. same upon nn�ire hom Ihr• <br /> APProVed lor Construction DAIe Ci1Y���d In r�Place P��bhc P��P�'�ry damaqnd thnrehy <br /> FINAL INSPECTION Date _- <br /> Approvod as Consiructed Si<�natmn ol Appbrant Dat�� <br /> �� Pl1BUCWORKSDEPARTMENT P✓ORK AUTIIORIT[� �Y THIS P[RMIT MUST BE STARTED WIIHIN <br /> � 9POOCedarSlreet 1P0 DAVS OF DAT[ P[RMIT IS ISSU[D AND THER[AfTEF7 IS 10 <br /> Everell.WA9BY01 �E DILIGENTLV PURSUFD TO COMPLETION. THIS P[RMIT MAV BE <br /> Phone 25�J�BB10 CANC[LIED�V THF CI7V UPON ANV STOPPAG[OF WORK ON 1HIS <br /> PROJCCT OVGR 90 DAVS DURATION / <br />