Laserfiche WebLink
�8�8�1p(q�.�{e� �� � Puni�rw�n�rermit• <br /> � -�-�-�d"3� <br /> AppliCelion For Binp Deni . � _ _d <br /> PUBLIC WORK� PERMIT °°°;a,:;�se°°° s <br /> le�a�oM �ee Pua S <br /> B�hnce0u� s <br /> Print or Type Gnly <br /> �.1il..�ac� i�Z.�r X �7�: 7 k��/c oti�76 Sc-�., 1�. 9 a� i a � _ <br /> I Owner Meiling Address Cily Zip Phone <br /> i — CC�,1/AL T I�L�I Nf� Ip�TC�_ <br /> 5 a rvu. <br /> Applicant Malling Address Cily 2ip Phcne <br /> Deecribe Proposed Work I <br /> a�w�-41���� ��a -�7� <br /> I �___/� — <br /> � <br /> -- - _ W <br />. prO�ecl Address(if known) _ � <br /> Attech lour(4)coples ol pinne lor propor•ed work� �raw 1�scale end note thn lollowinq es o�plicable: � <br /> • Property Linea • Centerllne of aheat � <br /> � Oulline and dimenslona ol all exletin0 and • Indicale North <br /> proposed etructuree on ttie Int � Show any proposed greding changes <br /> • Ex1911ng end propoved utilities • Show meesuremer s � <br /> �O NOT WRITE BELOW THIS LINE O <br /> PERMIT COND�TIONS <br /> t. All calle for inape..tlon shell be made 24 hra. in advance� phone 259-881 5. � <br /> 1. All work ehell be performad in eccordanca with ihie permit end cwreid Ci�y of Evere�t Design enc Constructian <br /> Slanderda and Specilicatlona. � <br /> 3. Call Loce�lon Underground Servlce 4B hrs.bafore you dlg. TOLL FREE NUMBER 1•800-424•5555. ' � <br /> �fs'G/C t�p,e'.�S f�E.ijin/l ido7 i�EQCii.PE.l) G�-.�S—$ � O <br /> ��� � <br /> � <br /> � <br /> a. <br /> _ <br /> AGKNOWLEDGEMFNT JF CONDITIONS <br /> The undersigned ownor/epplicant horeby agrees lo hold end savo herm- <br />— — less Ihe Cily ol Everel� Irom nny end ell claims for dnmages, coate, <br /> expenses, or ceuses of nclion thal mey arise beceuse of installalion I <br /> and mainlenance ol ihe improvement or other right-ol�wey use hereto <br /> epplied lor and further aprees to remove same upon nolice Irom the I <br /> Approvxd lor Conslruclion Dete City end lo repince public propertY damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Gons�ructed S�;nature ol Appl�canl Date <br /> everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BV THIS PERMIT MUST BE STARTFD WITHIN <br /> � 32�0 Ceder Slreet 1A0 DAVS OF DATE PERMIT IS ISSUED AND TNFREAfTER IS TO <br /> Everett,WA 98201 BE DIUGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE . <br /> Phone: 259�8815 CANCELLED BV THF GTV UPON ANV STOPPAGE OF WORK ON THIS <br /> PROJECI OVER 90 DAYS DURATION <br />