Laserfiche WebLink
DatA 7/Z$/95 1 � Z� � �ubi�cWorFSPe�mit• QS ( ( <br /> „ _ <br /> , Applicalion For eian oeP�.•_/�.gp00 1' I.9�_ <br /> or—�—t <br /> PUBLIC WORKS PERMIT °��°�°�°°«.;��° <br /> .o�a�F�� s <br /> Less/oni Fee Pa�a 5 /� <br /> /,, Balance Duc $_�6� <br /> Print or Type Only TO POSTING �����'�! <br /> Robert D Schuchard 3003 26th St Everett 98201 258-3156 <br />� Owner A^,ailin�� 4r.dress C�ty /in Phone <br /> Same <br /> ApplicaM Pda�linq Address Cdy Zip Phone <br /> �,c.�-::'i� i� •-��•.��. -:-�r;:::�,`:.i' <br /> Describe Proposed Work New d�lex and detached garage '�' " ' ' � - -` "-� <br /> S!'7Cu<`.'03�: <br /> ------- ;._�_; o:. i4.:01 - - <br />' — .._--. _..------ t= - ". -n <br />' G3o7 �4.�- ------ ��ca :�-�, _ W <br /> ----. —�—` �— .;V�C :i_�.0� � <br /> Prolect Address(�1 knownl _��9AInlQ.LC1dL�YCe_.. _ _���� <br /> r <br /> Attach four(4)copies of plans lo� uroposed worK � Drav: to �cai�r ann nole Ine, foiluwing as applicable. °-����• �-��C�,S'� � <br /> • Property Lines • Centerline nf street °-=�� �*��3���� � <br /> • Outllne and dimensions ol all existing and • Indicalu Norih ��!':-� '.;_,],I'^ <br /> proposed slruclures on the lot • 5ho�•any r,ronosed 9ratliq��c�,ianges � ,.�_ :,� <br /> • Existing and proposed utili�ie5 � Show mr.asurements - - - :��:.-,.... � <br /> � .., <br /> DO NOT WRITE B[LOW THIS LINE - ' ' '� � � O <br /> :!.:L'.l'f`=l':v. <br /> FERMITCONDITIONS , , "- , , <br /> 1.All calls for inspection shall La made 24 hrs.in advance•phone 259$810. ���c;p--�� �-,,��; ,�� � <br /> 2.All work shall be pedormed in accordance with this permit and cu«ent City of Everett Design and�Construction„ <br /> Standards and Specifications. - -� -` ' �� <br /> 3.Call Lccation Underground Service 48 hrs.beFore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> �, �c�' sP,,�•;�e -�r c<.j�l.e.t m�•sf 6e� ��y��! f.o �o��pv�. <br /> �, w�AtGr' a�,G+i�cG �vlvf{ L� A1.e��ec�, O <br /> G, Keep JtCe�� �✓t�� �z i l*-� s Gle��J r t a rl -h�.N�, � <br /> � <br /> 0 <br /> a <br /> �y� 4CKNOWLEDGLMENT OF CONDITIONS <br /> �v- <br /> 7he unAPr�ianPd o�aner/apphcant hureUy agrees�o hold and save harm� <br /> � less the City o� [verett Irom any ancf all ctaims (or damages. cosls. <br /> � � expenses or causes of action that may aris� Uewuse ot installation <br /> � and mamlenance o! Ihe improvemeM or oth^r right�of-way use hereto <br /> . � apN�ni; lor �nd lurihcr agrces to :emove same upon notice irom Ihe <br /> Ap roved for Consiruction �����' C�ty and to replxo public property damaged thereby. <br /> �--�''f�� /:13–ti L i �c�ic.4'�^ n n /) � (�� <br /> �FINAL INSPECTION Date J /�/ •� r ri�N.l' O-'�-�`� �S� � 3� ' 9 <br /> Approved as Constructed Siqnature of Applican! Date <br /> PUBLICWORKSDEPARTMENT WORK AUTHORI2ED B'f THIS PERMIT MUST BE STARTED WITHIN <br /> ���� 3200CedarSlreet tA0 DAYS OF DATE PEFMIT I� I�SUFD A�;D THEREAFTER IS TO <br /> ��T Everett,WA98201 BE DILIGENTLY PURSUEL TO COMPL�TION. THIS PERMIT MAY BE <br /> � �� Phone:259�8810 CANCELLED BY THE CITY U?ON APJ1'STOPPAGE OF WORK ON THIS <br /> PRO.iECT OVER 90 DAYS DURATION. <br />