Laserfiche WebLink
�o por�,.�� 9/zs/R/ w/AS-�u,Hs- <br />Date�y�(�' <br />Applicalion For <br />F'UBL.IC WOR�(S PERMIT <br />Print or Type Only <br />i �y .,��� caa <br />Describe Proposed Work <br />Project Address (if known) <br />Publ¢WorksPermi/tjw 9/0' c�- yL� <br />01tlp. Dep�. + 7��(� �SS _- <br />Publ¢ Works Fee <br />Total Fee � <br />�ess ApPI Fee Paitl S <br />ealance Due $ <br />�S�O <br />�'0 �{J — <br />SG ��- �� <br />Attach lour (4) copies of plans lor proposed work - Draw lo scale and note the following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimansions of all exisiiny and • Indicate Ncrih <br />proposed siructures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • SYow measurements <br />LI <br />PERMIT CONDITIONS <br />1. All calls for inspection ohall be made 24 hrs. in advance- phone 259-8810. <br />2. All work shall be pedormed in accordance with this permit and current Ciry of Everett Design and Consiruction <br />S}andards and Specifications. <br />3. Call Location Underground Service 48 hrs, before you dig. TOLL FREE NUMBER 1•S00•424-5555. <br />.Y�S' � <br />i l/J � // <br />�/✓ /Y c. �'•iY � 7� � <br />Apprcve Consl�� Date <br />' ,. ' /� Y/ <br />FINAL SPECTION Date <br />Approved as Consiruded <br />everett PUBLIC WORKS DEFARTMENT <br />� 3200 Cedar Sireet <br />Everett, WA 98201 <br />Phone:259�8810 <br />11/OS/90 5:0^cFM OOORHk466 <br />/ <br />H00025455 <br />ELDG 4823.26 <br />B S�iCH �4.50 <br />DFT.20 235.OD <br />ACKN7WLEDGHEIX�JJT OI$S�I(DGfIONS <br />� <br />O <br />� <br />� <br />K:K' <br />� <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less ihe City of Everetl Irom any and all claims for damages, costs, <br />expenses, or causes of 2ction that may arise because of installation <br />and maintenance of the improvement or other riyht-ohway u�� hereto <br />applied for and further agrees to remove same upon notice from ihe <br />City and to replace public properly damaged thereby. <br />/% �. ��- <br />Signature ot Applicant Date <br />W;if;h, AUTHORI�ED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DSYS OF DATE PERMIT IS ISSUED AND THEREAFT[R IS TO <br />BE DILIGENTLY PUPSUED TO COMPLETION. THIS PERMIT MAY" BE <br />CANCEL�ED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />