Laserfiche WebLink
�I . ,iYte5 � <br /> i CLEARING, GRUBBING, GRADING, AND EXCAVATION PERRIIT <br /> - Type or print clearly in ink <br /> ! PRESS HARD-YOU ARE MAKING COPIES <br /> � <br /> � Public Works <br /> I Everett,Washington -, PERMIT NO. ����_T <br /> � � � <br /> � APPLICANT (Undcrsigned) AND FIRM REPRESL•NTED, IF ANY:�r� " ''f ��` �-��"���-' �'� �' , <br /> i <br /> i <br /> HEREBY APPLIES FOR PERA1ISSION TO (Identity Quantitiesi. !_����•� '��� ' � � '��"%' � -'"��'-'"���' ��' � <br /> FOR ' �;, � . + . <br /> FFICE ATTHE FOLLOWING Lt7CATI0N (Sl •'�•;r' I.". (_ '�t._-"-".:'d��7��.—__ . ...-- _� <br /> i� <br /> ' �`bNEf , <br /> � DETAILED,SCALED DRAWING OF WORK TO BE DONE,ATTACH 4 COPIES <br /> ATTACH LEGAL DESCRIPTIONS � , „ , - - . <br /> ��� � � ' , .. . C.e..'"��(.�.,/yL� i '��'� . <br /> ' PERMIT IS VALID FOR 120 DAYS --�Jj ���j %%�['9 T ,fi��-�/v�-r� <br /> i (May be extended upon written approval from Public Works) ' r�� n�� ��� C'`G���;� <br /> ' 4 f�1�1�- •7 GJC'. <br /> II A NEW PERMIT IS REQUIRED IF WORK !-jf���!I,e TQ s?"f�.�r"r.�.1� � <br /> , HAS NOT BEGUN WITHIN 60 DAYS <br /> = �,���f�,^�;���,� ) <br /> � THIS PERMIT TO BE POSTED ON JOB SITE. <br /> � CALL FOR INSPECTION 259-8811 <br /> � 24 HOURS BEFORE BEGINNING OPERATION <br /> I <br /> The undersigned owner hereby agrees to hold and <br /> � I� zave harmless the City of Everett fmm any and all � <br /> '�, claims for damages,costs,expenses,or causes of <br /> � action that may arise because of the cleering, <br /> ' gmbbing,grading,and/or excavation activities <br /> � hereto applied for and further agrees to comply <br /> �. PLANNING/SEPA APPROVAL with all provisions of this permit. <br /> � j - ' � . .. . . ��f:� ` <br /> _i� / ,;i�-' < ..i. . <br /> • Signature of Applicant/Date of Application <br /> �, .:°. <br /> �i i �,�Y��r�. , <br /> I Atltlress <br /> � Approved for Construction�(PW) � � City Zip <br /> I: Issued (Bldg. e t) ` Date� Telephone Number Alternate <br /> i 2Q j <br /> �i App ed as Constructed FEE <br /> '-----. . _ . _. _ . . . . _ _ . _. .. _ . . . . _ . . <br /> � — <br />