Laserfiche WebLink
� AFPlicalion For �' <br /> ��%V�� PUBLIC WORKS PERMIT Date -s' � Q� <br /> �/ PUBLIC WORKS DEPARTMENT Public Works Pertni�p �� ��v/ <br /> 3200 Ceda;Street <br /> Everetl,WA 98201 259-8810 Building Permit p <br /> �000 <br /> TYPE OR PRINT ONLY Public Works Fee$ —� <br /> ��� s�a,�� y�35 nfi �- �� q � �ai��s ���� <br /> ner Mailing Address City Zip Phone <br /> � '�,�.,e% L�C/3��.,��—�✓or1� 9'��2�Q'� 'l��a.�-y�3Z <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work W <br /> � <br /> � ��/� <br /> V♦ <br /> PROJECT ADDRESS(if known) <br /> Attach tour(4)copies of plans for proposed work-Drew to scale and note the following if applicable: <br /> •Property Lines 'Outline and dimensions oi all e:cisting and proposed structures on the lot •Existing and s d utnilities � <br /> •Centerline ol street •Indicate North •Show any propo,ed grading changes •Show measurements � h�PR 2� 1996 � <br /> DO NOT WRITE BELOW THIS LINE """"""""""""""""""""""" <br /> PERMIT CONDITIONS: CITY OF EVERETT � <br /> 1. All calls for inspection shall be made 24 hours in advance-phone 259-8810. ��' �rmit Counte► <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> /` T�nG�e h'tv1'7�' 6e- /�S�ti�Ce o� 3 �'f Bia c� � <br /> 7�/'MM ['ti...6 �Lori� S'�.-�¢e7� O <br /> . Ob/30/96 9:41RM OOORM615 akk <br /> / <br /> NOOD96169 <br /> m�t�� sro.00 <br /> cHea; s�o.ou <br /> � <br /> ;;': <br /> ;=; <br /> , <br /> ACKNOWLEDGEMENTOFCONDITIONS - �'��ti.? <br /> The undersigned owner/applicant hereby agrees to hold and save harmless ' _ <br /> � � `�'— `l�" the Ciry of Everett from any and all claims lor damages,costs,expenses,or �� � <br /> causes of action that may arise because of installation and maintenance of '?' <br /> rovedior ruoli e theimprovementorothernght-of•wayuseheretoappliedforandfurtheregrees � _ ;-��'a; <br /> � to remove same upon notice Irom the Ciry and to replace public propeity -. �. <br /> dama ed t ereb ��!-� <br /> l� z �c_- �- .c� sl e v� <br /> INAL INSPECTION Date . , - <br /> Approved as Constmcted ,/ _ � - <br /> i ature of Apph a Date _ ' -„ . <br /> WORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO 8E DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />