Laserfiche WebLink
� �yy <br />C�N <br />' y <br />�C � <br />y� <br />�tl H ��d <br />�yp� <br />'Y. <br />OHd <br />��8 <br />��yy � <br />H <br />� H <br />pwN <br />��N <br />O � <br />-� <br />Date e-5-92 <br />Applicatian For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Goode Const. <br />Ppplicant <br />11217 — 60th St NE Lk Stevens <br />Mailina Atldress � <br />Describe ProPosed Work Detached aaragP <br />Proiect Address (if known) <br />v:mi�r.wo�tiar,�,n. — <br />o�oe orn� • 37616 _ <br />Punl¢Wa�ksFeo 5 <br />TOInIFeo <br />�esanoo� FeePa�a S <br />Bamnce �ue S <br />98258 334-9262 <br />2ip <br />Attach four (4) copies ol plans lor proposetl wo�k - Draw �o �cale and note Ihe following as applicable: <br />• Property Lines • Centerline ol sireet <br />• OuUine and dimensions o� all existing and • Indicate North <br />proposed struclures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measuremenis <br />� ' PERMITCONDITIONS <br />1. All calls for Inspection shall be made 24 hrs. in advance - phone 259•8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design end Conslruction <br />'� Standards arid Specilications. <br />� 3. Cail Location Underground Service 48 hrs. belore You dig. TOLL FREE NUMBER 1•800•424•5555. <br />�, � ,�-� � 'f �1.!��'��t..L,�l' <br />G I1 � l ��.. �.-z �.,. � � <br />s—c �l <br />�j G <br />qpproved lor Consiruction Date <br />FINAL INSPECTION Date <br />qpproved as Constructed <br />�A�PUBLIC WORKS DEPAFTMENT <br />3200 Cedar Slreet <br />Everelt, WA 98201 <br />Phone:259�8810 <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />�"' <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to holtl anA s�ve harm� <br />less Ihe Gty ol Everetl Irom any and all claims for damages cosls, <br />e.penses, or causes ot action that may arise because ol installatior. <br />antl maintenance ol ihe improvement or o�her right•obway use hereto <br />applied �or and �urther ag�ees to remove same upon notice from lhe <br />City and to replace public pwperry dama9ed thereby. <br />Signalure ol Applicant Dale <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />7d0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLE� BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />