Laserfiche WebLink
� 5�,�} c�1 •C3 3�' � <br /> �B�C�.� -1� ouoicwm��ae�mnr 1✓/� <br /> oao o.o�. � <br /> AOplicallon For <br /> i PUBLIC WORKS PERMIT "°'�"'°,'.". • <br /> .o,.,�.. <br /> �o�eooir..v.af o <br /> B.u�ceo„e t 7l�. �' <br /> Print or Type Only <br /> GGZ-�Zz�n/i��� <br /> �u�n�,��. 57 � a81 Z I�}o�3 i �,�et6� �.�N �Kto I �9—0mQ4 <br /> Owner Mailmg 11tlEress City Zip P�one <br /> �;�"y�I��o.2c. 99�5 zt3"`si�r.i� Lic.SIP,��w g��g 33y-5�1.� <br /> ApV��can� MailingA�tliess City Z�p P�one <br /> OescribePmo�seaWorh '31�0 �— �LU"�' IY� �'� �kW C�1'� e.u�rb IG� F1Pv <br /> ��i,,�NY Gc•e� anor �' w�lu�e wrN. C.ur1� I6uNr✓� a�d«,ntY� <br /> 2. S.� c� ' �ur <br /> GJuPr /6�14.W4� �CLG'f� L'�M4J C]t� LJr�j 16J}�P✓ r, f W <br /> ProjeclACdRss�llknoxnl �'���1 ��L. ������ �� • � <br /> Allach low�J)copios ol plans br p�oposed work�Oiaw lo scale nne no�e Ine following as npplicable�. � <br /> •P�operW Lmes •Cenletlme ol slreet �w <br /> •OWline anE tlimensions ol an eRistmg and . •Indicate•Nonh V� <br /> prpposetl 5irucWres on Ihe lot •S�ow any prpposetl gretlmg c�angos <br /> • E�isbnq antl OmposeE u�ililics •Snow measuremenls M <br /> W <br /> 00 NOi WRITE BELOW TMIS IINE O <br /> PERMIT CONDITIONS <br /> 1.All ca�ls br insvection shell bo made 24 hrs.ln advance-phone 259•8810. � <br /> 2.All work s�all be pedormed In actordente witn Ihis permit and current Ciry ol Everetl Design e:�tl Conslmction <br /> Standoras and Specilitations. <br /> 3.CaIILocetionUndergmundSurvice48hrsbcloreyauaigTOLLFNEENUMBER�•8�',0�424•5555. � <br /> 7 ,SOr:; !uf c�+c� 2'mct2 C'X�Sfinp p''/ITNa}/S. .Pr-inS�q�! O <br /> ✓ <br /> S.d.��...C.E� e�.-6 $'J�Ne•- p¢r e�%y Sfi..,�n.-o�s 3a. � .3n5� � <br /> .S jnS�1!! /a;r✓ c/ii�z�✓n� �.- ci�j S�Ri>o�n..o/ ft' 30] N <br /> C. k��P f��y Sf.-ccf ll��n of ae'! fin,eS , /'1 <br /> V <br /> � <br /> ACKNOWLEOGLMENT OF CONDITIONS <br /> The undeesignetl owneqapplicant�ere�y agrees Io t.oltl and save haem� <br /> — less lhe City ol Everelt irom any xntl all claime lor tlamages. cosls. <br /> //�r � ex0enses. nr tauses of atlion thal may a�!se because ol installalion <br /> .�) �) / antl r.ninlenance ot um..-p��vemen� .� ot�er nghl�o4way use M1erelo <br /> �:•' ap�.ued lar and lurt�cr agrees to�emove samc upon notice Irom t�e <br /> Appmve0� Conslm n � � f,ity anC to reGlace pubbc prope�ry dama0etl Ihereby. <br /> � ii•if -3a �w� il �.u-f-1� /o-/S-93 <br /> FIN�L!NSPECTION ���� <br /> Apn�evetl as Conslmcletl Sigwime ol Appt¢anl Dale <br /> � PUBLICWORKSDEPARTMENT WORK AUiHORIc'ED DY THIS PERMIT MUSi BE STARTEO WITHIN <br /> 180 OAY$ OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3tC0 Cetlar Slract BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAV BE <br /> Evnroll.wA9B201 CANC[LLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> P�ono:259�8810 PROJELT OVER 90 DAYS DURATION. <br />