Laserfiche WebLink
TO POSTING_ �' � ��� �.1l�0 � <br /> PUEIic Worka�armit� /�t;3� <br /> Date 4-1�-92 � aia9 0�0� • <br /> - Application For <br /> pUgLIC WORKS PERMIT Pu0licWorksFee s <br /> Tolal Fee <br /> Less A001.Fee Peid s—}�—� <br /> Balance D�e S <br /> L Vv <br /> Print or Type Only <br /> Everett 2 259-7120 <br /> Thomas Turner 308 Heather Rd phone <br /> pwner <br /> Mailing Address City Z�P . <br /> OHpOT CIIY Zfp Phone � <br /> qpplicant Mailing Address <br /> Describe Proposed Work ara e <br /> W <br /> 308 Heather Rd � <br /> Proleol Address(it known) �----�— � <br /> Attach four(4)copies ot plans for proposed work• Draw to scale and note�CQo1;eWine of stPee�able� � <br /> • PropeAy Lines � Indicate North <br /> • Outline and dimensions of all exisling and � Show any proposed grading changes � <br /> proposed struclures on the lot � Show meesuremenls <br /> • Ezisting and proposed utilities <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS � <br /> 1.All calls!or inspection ahell be made 24 hrs.in advance-phone 259-8810. <br /> 2.All work shall be peAormed in eccordance with lhis permit end current City of Everett Design and Construction � <br /> Standards and Specitications. <br /> 3.Cali Locetion Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800'424•555 • <br /> CO���' ,��.� �.o��- �� � ,���.� .�-,� �ti���� Q <br /> d,���� � -� �- �..��. � <br /> ' _.j/-J�,' . .���; �`��' N.O�� � <br /> :o�o��,a,,.., . a <br /> -� n� 6qq.D� <br /> _ co.C_f! ^i, =.�1 <br /> ;;iy"r„' -�C.-- <br /> r!'L-, ="...50 <br /> _(} ACKNOWLEDGEMENT OF CONDITIONS <br /> 11� <br /> �V— The undersigned owner/applicant hereby agrees to hoid and save arm- <br /> less the City of Everett irom any and all claims for damages. costs, <br /> J ezpenses, or causes of �.,�ion that may arise because of installetion <br /> ' �� ' / and maintenance of the improvement or other right•of•way use hereto <br /> ��/ 7 -Z5���2 applied for and further agrees lo remove same upon notice irom the <br /> Dale City and to rep�ace public property damaged thereby. <br /> Approved for Con tr �on i �� -���/ <br /> //iG�i'�r-- � l�� 6 �i �'1i <br /> Date Date <br /> FINAL INSPECTION Signawre ot APPlicant <br /> Approved asConstructed WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT I� ISSUED AND THEREAFTER IS TO <br /> 3200 Ceder Street BE DILIGENTLY PURSUED TO CG'MPLETION.THIS PENMIT MAY BE <br /> Everetl,WA 9820� CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THI3 <br /> Phone:259-8870 PROJECT OVER 90 DAYS DURATION. <br />