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<br /> CLEARING,GRUBBING,GRADING,AND EXCAVATION PERMIT
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<br /> PRESS HARD-YOU ARE MAKING COPIES
<br /> Public Works
<br /> Everett,Washington PERMIT N0. +� /' �-'� �
<br /> APPLICANT(Undenipned)AND FIRM REPRESENTED, IF ANY:�G'FJ li L �. !(�/,=a R/ �
<br /> ( HEREBY APPUES FOR PERMISSION TO(Identify Uuantities)h1 r'�%r 4 ���'i7�;�1 ; v � �% r7 S n "' �7i�i' 7 Fi�>>v � '
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<br /> I DETAILED,SCALED DRAWING OF WORK TO BE DONE,ATTACH 4 COPIE�
<br /> ' ATTACH LEGAL DESCRIPTIONS
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<br /> � PERMIT IS VALID FOR 120 DAYS � �, f ,r� ��� ^;J-�D�� �j.+'_%�_��
<br /> i (May be extended upon written epproval from Public Works) 1�
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<br /> � A NEW PERMIT IS REUUIRED IF WORK �1. ��/`'�� � �C�=��r k �?l//�'I/'}C�1_,!i
<br /> HAS NOT BEGUN WITHIN 60 DAYS
<br /> ; Ci�ik;lic,°� �'"/LG �;J;��;t�/i'�%�f.�
<br /> THIS PERMIT TO BE POSTED ON JOB SITE. J.N���=- ��"n�r�'1�'�rL ��y
<br /> ! Arv����ti T �s s«��� ,�,;=���._����.r
<br /> CALL FOR INSPECTION 259$811 �+�t � ����/,�� f3 �->��/r� ?�' /iJ�S
<br /> 24 HOURS BEFORE BEGINNING OPERATION
<br /> ! `?l� �� �� �~/�1,1=ti!.�/�'� `�f,Y'f%'� .'�� %',f7'.�',�/�C.I !Q /�^'y`ll=;'!='A,� �- .
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<br /> � L_ � -q-�, �'��.��f���`� S �s ���- The undenigned owner hereby agrees to hold md .
<br /> �c- i � save harmless the Ciry of Evarett from�ny and all
<br /> claims for damages,costs,expensa:,or causes of
<br /> action that may arise because of the clearing,
<br /> � grubbing,grading,and/or excavation activities -
<br /> � hereto applied for end further agrees to comply �
<br /> PLANNING/SEPA APPROVAL with al�provisions of this permit.
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<br /> Signature of Applicant/Date of.Appliwtion �
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<br /> Aatlress
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<br /> ��. -Approved fof Construction (PW�,I � City Zip
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<br /> ' Issued (Bldg. Dept) _ - ' � ate Telephone Number Alternate
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