Laserfiche WebLink
w <br /> � �flte B�ZG�HS PUCIic Worke P��It��__ . <br /> /1 <br /> Bldp.Dept• <br /> Application For <br /> PUBLIC WORKS PERM ��� PublicWorWFea = <br /> Tolel Fea <br /> ! ���� 1 ���� Lafa AOG�Fee Pe1E f <br /> Balance Due 5 <br /> Print or Type Only <br /> Joe Pignataro 484808 Evergreen Way Everett 98204 259-8104 <br /> Owner Mailing Address City Zip Phone <br /> Badger Construction 11012 State Road 525 Mukilteo 743-9117 <br /> Applicant Mailing Address City Zip Phone <br /> Construct 7[%di�t Auto Retail Sales <br /> Describe Proposed Work <br /> W <br /> Prolect Address(if known) 10520 EVergreen Way � <br /> Attach four(4)copies of plans for proposed work• Draw to scale and note the following as appiicable: � <br /> • Property Lines • Centerline ot street � <br /> � • Outline and dimensions of ell existing and • Indicate North <br /> propoaed structures onthelot • Show any proposed grading changes <br /> • Existing and proposed utilities � Show measurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1. All calls for(nspection shall 6e made 24 hrs. in advance- phone 259•8815. � <br /> 2. All work shall be pertormed in accordance with this permit and current City of Everett Design and Construclion <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. 6efore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> y �� �f�l`'o%2� �,g�J�1` d�%i�� ��l�S <br /> 0 <br /> s �f/�3 ������' �� .��i�: '... <br /> ��_ �'F'viE'�f�/dC`E Gr:tP�",f,�JTF�-: �a� E�i�G.f'�a V♦ <br /> Gvh'Y /�0'//'.�o���i -.✓i�' ,��' �j� //�j� O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less !�,ie City of Everelt irom any and all claims for damages, costs, <br /> � expenses, or causes of action that may arise because of instatlalion <br /> 9 , ��� and maintenance of !.:e improvement or olher right•of•way use hereto <br /> applied for and further agrees to remove same upon notice from the <br /> pro ed fo onst ion Date City and to replace public property damaged thereby. <br /> r � <br /> FINAL INS CTIO ' � � /�`�J /�� ��)/�� <br /> ppproved as Gonstructed <br /> Signa o i aps� ��[ ate <br /> WO AUTHORIZ�D BY THIS PERMIT MUST BE STARTED WITHIN <br /> everen PUBLIC WORKS DEPARTMENT 7g0 AYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION.TfiIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED BY THE CITY UPUN ANY STOPPAGE OF WORK ON THIS <br /> � Phone:259-8915 PROJECT OVER 90 DAYS DURATION. <br />