Laserfiche WebLink
Date�� <br />AnPlicallon For <br />PIJBLIC 1�VORKS F�ERMI�" <br />Print or Type Only <br />Img h <br />ng Address <br />Descrme Proposed Work <br />Project Address lil knuwnl <br />Ury <br />Ciiy <br />C.ip <br />Attach fow (4) coples ot plans for proposed work - Draw to scale and note ihe followmg as appficable�, <br />O Property Lines <br />• Outline and dimensions ol all existing and <br />propused structures on the lot <br />• Existing and proposed ulilities <br />Fi�UI�� W�r4b ✓••rniil � Q_ � . <br />E3i�t9 Oonl � .' ���41�--- _. <br />a,�e��� wo,k� Fo�• <br />io�ai F..e S _ _ _ <br />iess anni Fe�• oo�n 5 _ <br />e�i.,�� �� n,��, s <br />• Centerline of sireet <br />• Indicate Norih <br />• Show any proposed grading changes <br />• Show measuremenis <br />�,� <br />Phnne <br />PERMIT CONDITIONS <br />1. All calls fur inspection shall be made 24 hrs. in advance - phone 259•8810. <br />2. All work shall be pertormed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Localion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-500•424-5555. <br />� � • <br />i i <br />/�.l�Cc�- <c�c-�.l,�_/�-_�,.�,�<f�/L�fl` /.c� z z<<�/ ,� is 8Y <br />Approved for Construction <br />ACKNCWLEDGCI =t<1 OF��ONDITIONS <br />W <br />� <br />� <br />� <br />� <br />The undersigned ownei/applicant hareby agrees to hold dnd sav= harm- <br />— less the Cdy ot F.verett I��m any and all claims for damayes. cosls. <br />expenses. or wuses of achon that may arise because ol installation <br />and maintenance of ths improvement or other �ighhol-way use hereto <br />— I appl�?tl foi and further agrees to remove eame upon notice trom the <br />Date �,�y ���d to replace publ�c propeny tlamaged thereby. <br />FINAL INSPECTION ���e � — <br />Approved as Constructetl Si9naw�e ol Appl�cant Da�e <br />everett PUBLICWORKSI�EPARTMENT `N('RK AUihOR12ED B\' THIS PERMIf MUST BE STARTED WITHIN <br />320CCedarStreet 180 DAYS 0= DATE PERMIT IS ISSUED AND THEfiEAFTER IS TO <br />F�-aretL WA98201 BE DIUGENILY PURSUED TO COMPLETION. THIS PERMIT MAY Bc <br />�'J Phone�.259-8810 CANCELLEC BY THE CITV UPON ANY STOPPAGE OF WORK ON THI.: <br />PROJECT )VER 40 DAVS UURATION. <br />