Laserfiche WebLink
, <br /> __ . __ <br /> y�. �r �-- _. _-------�. ,,-�-� � , -�-�-_��<��--��,;.�:--�:.; r--:�;.- , , <br /> �--�� _ - - -__ <br /> �-���, - <br /> O � ' ` � ��Glrc Worka Perm t• . <br /> �Q fl � Date—�f/9 90 .. <br /> �j�y e�nq uev� • 90/:5328 _ <br /> � qpplication For � <br /> PUI3LIC WOR�(S PER�UIIT r�e,cw��xarPa <br /> M � -- <br /> H <br /> � � Tolel Fea S <br /> ��� less Pno� �nc Paid 5 <br /> ��� Baienc✓Dun $. <br /> PriM or Type Only <br /> !p <br /> H C <br /> �C��1 �, �rnr t Frhm1 M_�ict ��in r i� F.,..�ert oa�nv 339-4226 <br /> „ x Owner Mailing Address City Zip Phone <br /> ["y5C <br /> Ownor <br /> H�H] ' Applicani MnilingAtldress City Zip Phone <br /> �w <br /> �y W <br /> �O Describe Pwposed Work n��ol W�rcial Dui191na at. Everett tiiqh 5chonl <br /> dl� <br /> O t� �, <br /> ' �I � <br /> , Projeq Address(if known) '�• — — � <br /> �' Altach lour(4)copies ol plans�or proposetl wo�k-Oraw to scale antl note the lollowiny as applicable�. � <br /> �� • proFerty Lines • Centerline of street ♦A <br /> • OuUine and dimensions of all ezisting antl • Intlicale North V� <br /> � proposed s�ructures on lhe lot • Show any proposed gratling changes <br /> �� � • Exis�ing antl proposed utilities • Sl;ow measurements M <br /> ' WI <br /> � ��'r �I DO NOT WRI7�BELOW THIS UNE O <br /> - � PERMITCONC�ITIONS <br /> 1 � 1.All calls lor inspeclion shell be made 24 hrs.in advanct� phone 259•8810. � <br /> 2.All work shall be pertormed in acwrtlance wilh ihis permit and currenl City ol Everett Design and Construction <br /> � 1_� Standards and Specifications. <br /> ��� } 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMOER 1•S00•424•5555. � <br /> ' � j ��/,��� ��o�'z .�.��: ,�. r �:�;� ��-,�;� :� � <br /> � � �i <br /> — � ,� <br /> �./�//'/w �.a�".`'G'�.'1 -- � . <br /> �/ � '��� ��(�� � I <br /> 7� ' O <br /> , � '-� i a <br /> ; I <br /> i <br /> I ACKNOWLEDGEMENT OF CONDITIONS <br /> I ''�� I The undersigned owneriapplicaM hereby aprees to hold and save harm- <br /> �� less the City ol Everett Irom any and all claims for r:amages. costs. <br /> � � expenses. or causes of aclion that may arise because ol installation <br /> � and maintenance of the improvement or oiher right-ol-way use hereto <br /> _. apPlied for and lurlhc� agrees to remove same upon notice Irom Ihe <br /> � Approved lor Construction Date City and ro renlace puUlic propeny damaged thereby. <br /> � FINAL INSPECTION Dale <br /> II Approved as Constructed Signalure ol AppGcant Date <br /> I eve�clt PUBLICWORKSDEPARTMENT W�RK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarS�reet it30 DAYS OP DATE PERMIT IS ISSUED ANC THEREAPTER IS TO I <br /> ` � Everetl.WA96.'01 �E DILIGENTLY PURSUED TO COMPLETION.THIS PEFiM1T MAY BC <br /> Phone:259�BB10 CANCEI.L[D BV THE CITY UPON ANY STOPPAGE OF WORK ON THIS I <br /> I PROJEGT OVER 90 OAYS DURATION. <br /> �i ______ ___.._ _ - __ _ <br /> . _ . . _ _ . . . _ I <br />