Laserfiche WebLink
��x <br />C H <br />� <br />�1.�� <br />N <br />'RI N �il <br />� <br />x <br />��d <br />�N <br />4• <br />�y <br />M <br />� M <br />��y� <br />OW <br />� <br />Date� �' <br />qpplication For <br />PUBLIC WORKS <br />Print or Type Only <br />F�ERMIT <br />3 O.r � / <br />Puo�2 Worha Petm�t � 9;�- <br />0�09 De01. • <br />FuDLc Wa�b fee s —� <br />Totel Fee <br />LessPoo! FeePx�O S�o <br />Baiance Dae s G � � <br /><�^L���� — — ZiP Phone <br />Mailing Addre55 ���Y <br />APPIiCa.il / � <br />Describe Proposi�d \York <br />Project Atldress bf k��pwn1 <br />� <br />AttaG� lour i4) coph:s o� P���S lor proposed work • Draw to sca�e and �ote � C1o1ie�ine ol str�eei able: <br />• Propr�ty Lines • Indlcale Norih <br />� Or;��ne and dimensions ol all e*istmg and � Show any p�oposetl gradinc� changes <br />proposed svuctures on the lot • Show measuremeMs <br />• EriStir�g a�d proposed u�ilit�es � <br />� DO NOT WRITE BELOW iN15 LINE <br />htaC /un a <br />PERMIT CONDITIONS <br />1. All calls for insDection shall be mude 24 hrs. in edvance • phone 259•8610. <br />2. Atl work shall be perlormed in eccordance w�th this permit and cwrent Ciry ol Everett �esign and Conslruclion <br />Standards and Specifications. <br />3. Cail Localion Underground Service 48 hrs. belore you dig. TOLL F';EE NUMBER 1•800•424•S55 . <br />. S S /�7t�C<i'�C<1 C7f/ ��i�- <br />/� Nn �C4 ��.•,, j f��.•.»,�e�� n., slo�� : a � <br />,S?cv � .:Y.; n ��j� �'�,�n� n Dnl�d ,a -/0 -9� �Co��y �/fa �hcc� <br />�} ,/ /� �i'GfJ �'l� �C �'i:ino✓r'. <br />.�7�.ia^ '�774��/.[7� i�lr.� IC'I"' <br />S=C <br />l <br />. <br />FINAL INSPtI. � ivrv <br />qpproved as Constructed <br />��PUBLIC WORKS DEPARTMENT <br />32D0 Cetlar Street <br />cvaretl, WA 98201 S <br />Phone:259•BB70 <br />IHITIAL INSPEC�II)[ <br />KIRK BROOKS <br />DATE �-� <br />Dntv <br />W <br />� <br />� <br />� <br />0 <br />� <br />� <br />O <br />a <br />ACKNOWlEOGEMENT OF CO'�DITIi:V`i <br />i he undersignetl owneUapplica�t he�ehy aqrees lo hold and save harm� <br />less Ihe Cdy ot E��erett Irom any and . il claims lor damagos. cosis, <br />expenses. or causes oi action thal may arise because ol imtallatinn <br />and maintenance ol the improvement or olher right�oFwa•; use hereto <br />applied lor and Wrther agrces to removo san'�e upon neiir,c Irom Ihe <br />City ����1 Io replaCe Publlt propErry damaged lhereby. <br />�; � ��� � - �/- 93 <br />'^" / Date <br />Signalure q APPh nt , <br />BORDAYSTOF DATE PEFMIT ISEISSUED ANDBTHEREAFTER ISHTO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />