Laserfiche WebLink
/ <br /> �ate�-`�19Z 3 7�_ <br /> Pu�Im Wo�A�Parmil� <br /> Application FCr Biea neni • <br /> PUBUC WORKS PERMIT Pu�ToWFeefea s <br /> lae��ppl Fee PeiC S__ <br /> Print or Type Only B��cnce�ue S I <br /> �66'_FBict y�( �J�� <br /> fi"N-c aoE,�✓6 c,a. P p, (3o�c 3�0,, �/ ���G s���T��w�, 9P'Lo, <br /> Owner �MailingAddress City Zip Phone <br /> S�, � <br /> Applicant Mailinq Address City Lp Phone <br /> Describe Proposed Work �/��`�l S/�� �'`��2 r t� ��r��'�r�L�.S _ <br /> Projecl Address(if known) _ 300� L✓. �'as�%�o ,e�✓. __ OCT p g 1gg2 � <br /> � <br /> Atlach loui 14) copies of plans lor proposad work• Draw to scale and note Ihe lollowing as appticablo:�................................ � <br /> • Property Lines • Cemariine of s�reet CITV OF EVERETT � <br /> • Ou�line antl dimonsions of all exisling and • Indi�at� Norlh Buildinp Oivislon <br />� proposed slractures on iho lot • Shuw eny proposed g�adinq chenges <br /> • Existing and proposed utilitles • ShoN�measuremenis � <br /> DO NOT WRITE BELOW THIS LIPl�: O <br /> I PERMIT CONDITIONS <br />� 1.All calls for inspection ehell be made 24 hrs.in edvance•phonx 25A•881 O. � <br /> 2.All work shall be pertormed in eccordance with this permit and currant Gity ol Everett Design and Construction <br /> Stendards end Specifications. <br /> I3.Ce!I Locatlon Underground Service 4B hrs.before you dig.TOLL FAEE NUMBtR 1•800�424•5555. � <br />( f� S�f� Wa.-,E r� .,� do•,e j.�r pCn.,s aPp.o✓ed6� � Cr�y O <br /> fLqnnin� 4nCl��i6CiC �do�'.FS e�e�o^finen7`S O�/ /0-9-9� <br /> I � �CUin /n TOr r/�74 �� /�nCffion CD ' ./C�^ .$''{O�` q/nagP S�If N <br /> /s' r�a/" ��ro veo� e fo:l / ✓ <br />' �ConS C2o Cso Oi�/ui4�cn 4.-a/e� O <br /> /jlvr t� dera: ) wil� nea z`a e PG✓rsc rcSn ✓�c� !�� � f t/fj/ a <br /> 10/2/ 9 Se �.- d� , b�f' t �his oa.�et�ir h iS �P• <br />� ACKNOWLEOGEMENT OF CONDITIONS <br /> The undersigned owner/applicanf hereby agrees to hold and save harm• <br /> less Ihe Cily of Evere�t from any and all claims lor damaBes, cosis, <br />� � % expenses, m causes of action that may arise because of installatlon <br />� ' / /n 9 �,� and mainlenance of ihe improvement or other righbol�way use her�3lo <br /> applied tor and Iwiher agrees to remove same upon nolice Irom the <br /> Approved lor�nslruct� a�e City and t�ic ProPertv '^eqe� /�/J Zr <br /> FW L IN/TIO ate <br /> Approved as Constructed Signature ol Applicant Date <br /> � PUBLIC WORNSDEPAPTMENT WORK AUTHORIZED BY THIS PEFMIT MUST BE STARTED WI7HIN <br /> �80 DAYS OF OATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> J200 Ceder Street LF_ DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAV 8E <br /> Everelt,WA 98201 CANCELLED BY THE CITV UPON ANV STOPPAGE OF WORK ON THIS <br /> Phone:259•0010 PROJECT OVER 90 DAYS DURATION. <br />