Laserfiche WebLink
� �PPlication For r. <br /> PUBLIC l _ ORKS PERMIT Da <br /> PUBLIC WORKS DEPARTMENT Pubi(c Works Permit p <br /> 3200 Cedar Street <br /> Eve�ett,WA 98201 259-P,il10 <br /> Building Pertnit N <br /> TYPE OR PRINT ONLY Publk Works Fee S <br /> Plan Check Na: B 53199 SEPA <br /> Aoulicat.Date: 10/14/96 <br /> �'^� ..ob Ad�rese: 10515 EVERGREEN WAY Phone - <br /> Owner: DWAYNE LANE <br /> Tanant: <br /> Propooed Uae: STORAGE <br /> Applicant Deac. of Work: <br /> STORAGE ADDN-TWO STORY Phone � <br /> D6SCribB PropOS9d WOfk_ pgFIC6 S8T JOB S8T <br /> APPROVED FOR PERMIT: DATS_/_/_ gy � <br /> � <br /> PROJECT ADDRESS(if known) � <br /> Attach four(4)coples of pians for proposed�york-Draw to scale and note the following H applicable: � <br /> 'Property Unes 'putline end dimenalons of ell exlsting and proposed structures on the lot •Existfng and proposed utiltties O <br /> 'Centertine of street •IndMate North 5how any proposed grading changes 5how measuremects <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for irspection shall be made 24 hours in advance-phone 259-8810. <br /> 2.All work shall be pertormed in accordance with this permit and current City of Everett Design and O <br /> Construction Standanis and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> �I/ <br /> . O <br /> a <br /> 'IIRLIC WO�KS ►�p�Al'� <br /> tiOT 9EOdJAfiL11 <br /> 'y-� <br /> ►aTF.-�� 9&_......- <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The unders(gned owner/applicent hereby agrees to hold and save harmless <br /> the City of Everett from any and all claims for damages,cosb,expenses,or <br /> Approved for Consiruction Date causes of actlon that may arise bacause of Installation and maintanance of <br /> the improvement or other right-of-way use hereto appBed for and fuAher agrees <br /> to remove same upon nottce from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved aa Consiruqed y'� <br /> Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTE�WITHIN 180 OAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DIL�GENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />