Laserfiche WebLink
/�%� 9��ak- ��� <br /> , � , � ApplicationFor �— �-9Q <br /> ���� PUBLIC WORKS PERMIT °a'e � <br /> PUBLIC WORKS DEPARTMENT Public Works Permit k Y/ y2 <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 <br /> Building Permit!t <br /> S <br /> NPE OR PRINT ONLY Public Works Fee$ <br /> .lohru LRK(��tNi aCoS3 . s <br /> �rq�s �Q✓�'��fes 5�03 WESFb2� 1,uYND �AN�o��Bc U��y� Go�f-9zf-�3z& <br /> Owner Mailing Address City Zip Phone <br /> �"lE2c E .ks N on 9�2Z3 <br /> ��trvn 'rerr/ti��b�� �S'S2p3^�AuP�tIE �r�i..�y'}' 360 �Sl 97a-7 <br /> Applicant Mailino Address City 7.ip Phone <br /> DescribeProposedWork Gra6iN9 .4�1c9 '�' fiE _ �`� 1 � 1 <br /> �--- Ii1 <br /> � <br /> _ C2z4 3ao Glt�nw���1 � � <br /> PROJECT ADDRESS(if known) Nv � <br /> Attach four(4)coples ot plans for proposed work-�raw to scale and note the lollowing if applicable: O <br /> •Property Lines •Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utili'�ies <br /> •Centerline of street •Indicate NOAh •Show any proposed grading changes •Show measurements � <br /> 00 NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: Z <br /> 1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. O <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Cail Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> � P..�,- �,.w-.e �r��s o <br /> 09-7.4-SE 4.�'A�ti <br /> a <br /> # °n"_�29 <br /> '.7Tfi�=rt �J4.�J <br /> r'!u/fiVid �4uoi2 <br /> FU/INS� �'_54,�e <br /> i�TAL �0��:.5� <br /> �=?-i!_��-. __- . ..� <br /> v"i':c�8''i <br /> � , <br /> . . � �� n� ���, <br /> ACKNOWLEGGEAtENT OF CONDITIONS <br /> `� The undereigned o�vner/applicant hereby agrees to hold and save harmless <br /> � G� the City of Everetl from any and all claims for damages,costs,expenses,or <br /> Ap roye for C ' tion Da� causes of action th�t may arise hecause ot installation and maintenance of <br /> ( tho improvement or other nght-o(-way use hereto applied lor and further agrees <br /> , to remove same upon notice from ihe City and to replace public property <br /> damaged thereby. /r�,/� /^ /� (� Q � <br /> FINALINSPECTION Date � �^�'��/�` ,�,/ Z�RI.�'�r " � •` ' ( �� <br /> � Approvecl as Consiructed � � �/� < /�'} /� , �� <br /> '\ � v��/\d'b�-�-t'— <br /> Si ature of Applicant !-�.r l+��}jf A-��ry-� ���fr�k1�S. � <br /> o c'S/ <br /> ORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 100 DAYS OF DATE PERMIT IS ISSUED AND THEREAFZER IS TO BE DILIGENTLY PURSUED TO <br /> MPLETION.iHIS PERMIT MAY BE CANCELLED BY THE CI7Y UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DUflAT10N. <br />