Laserfiche WebLink
c � ro <br />M <br />H <br />C H <br />7 H V: <br />K�n <br />H � <br />ro M � <br />N M <br />lt O � <br />o.yi ° <br />H l�*1 O <br />c� • n <br />� ~ � <br />y f <br />O V~1 y <br />O N <br />n O p� <br />C C <br />ti � � <br />H O vyi <br />Dr�te 17117190 <br />Application Por <br />PUBL@� W��KS PERMIT <br />Print or Type Only <br />...:: i,.: i - y0/257.'3- -- <br />a�oi�� w�,�.,. r,.o <br />roc'�re � <br />�.�s:anoi rocvem 5 <br />ea�a�ro Dcn S� <br />Dethel Baptie:t Church 2625 Noyt Everett 98201 252-0249 <br />Ov:ncr MailingAdAress City Zip Phom�, � <br />_ Odnei _ <br />ApPhcant MaJing Atldress Ciiy Zip phnn,. � � � <br />Dvscribe Proposed Work _ Tendpt�IpprOvement _ _ <br />t--ioiect Address li! known) 2625 <br />,biarh Inur 14) copies ol plans for proposed v.rork- Dmw lo scale antl nole �he loi;owing as apPLcal�lo- <br />i Properry Lines • CeNcrline ol streel <br />U Gutline nntl dimensic s o� �II exisiing and O I-�rficale Norih <br />P'�f+oseU S�nie�ures on !he lot ! E hoa Uny propo_:eii g. �[pnq chanyrs <br />U Lzistinq ,mtl pr,-.Pwad Wdibc,°: • Show rn�asuremenls <br />DG NO7 <br />� i�ERM111T CONUITIO�lS <br />i'� d 1. All calls for inspection shall be m;Ae 24 hrs. in advance � phone 259•8810. <br />�q � 2. All work shall be peAormed in accordance wi�h Ihis permit and current Clry ol Evemlt Desl9n nnd Construchon <br />�, Standards and Specifcalions. <br />. 3. Call Location Underground Service 4B hrs. bafore ynu tlig. TOLL FREE NUMBER 1•S00•424-5555. <br />/��i�C.c c�,.,�'� %�,a.,,,,.1 �,: l` ;'<, :_ �. ,. ,%� <br />'Y` <br />f,� pi rl I�-r C � i.;�,.,r_._ _ _.. __ <br />�INnLII I.CiION � <br />i�UG�ooc._ f;�qp�iur��.,; <br />I�•��It PUBLICWOP.NSD'ePARTMENi <br />/i� S20(` Cedar S:reet <br />�� n ��n .vn �eaqi <br />11 �_SIU <br />��l �!� � - <br />%��-/9-�c' <br />e <br />nCKtJ6l�'LEDGEP.�FHT OF GONDITIONS <br />The untlersigned ov: n��r�ipplicant herchy aflrees to hoW anri cz�..- h.,;,,. <br />— less �he Clly of Evcre�t Irom any antl all cla� ns lor aam.�q"v, c„�.,c, <br />repenses, or causr,s ol action `:lat may unse 6eCause of in51nlC;i-�n <br />;r.�.d maintenance ol Ihe impraremeni or olher nyhl-ol-w:ri �.r,�� h,�n:9a <br />— ,,pphed lor antl lurlher a�rees lo remove snme u� rn r.t�-.� ����rn thu <br />�' �'' , Cny antl to replace public properry damaged IhereL�. <br />5��9na�iue ol APPIi[an� .. _. . . —b.�l�. _- <br />WORh AUT!{pRIZED BY THI� PERM T MUST BE STAR7ED WIiHi;; <br />180 DAVS OF DATE PERMIT IS ISSUCD AND THEREAfTER IS TO <br />3E f)ILIGfMLY PU1' ��r-D 70 CONPLF_TION. THIS FERIdIT t.1iY P,i <br />CA'�( I l� r�: 'Y �NI ('II'( CI � I �V S�.'(iG fv bI. ��i 11�1h1:0'. ii�_ <br />I'aiJll(li��_il�, ;I'.� .IiON <br />