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� �� <br /> CLEARING, GRUBBING,GRADING,AND EXCAVATION PERMIT <br /> Type or print clearly in ink eve re tt <br /> PHESS HARD-YOU ARE MAKING COPIES <br /> Public Works <br /> Everett,Washington PERMIT NO._ <br /> APPLICANT(Undersignedl AND FIRM REPRESENTED,IF ANY: �� - ' � � � ` <br /> HEREBY APPLIES FOR PERMISSION TO (ldentify Quantities) <br /> � ,�., � ' .�' �',a i , . - <br /> -;i' <br /> E�f��F/l�l� ATTHEFOLLOWING LOCA710N(8) "�` t � y <br /> V➢r ' V f M ' �t�r�' �y�.J <br /> �x ��y :�� <br /> pNIY <br /> DETAILED,SCALED DRAWING OF WORK TO BE DONE,ATTACH 4 COPIES <br /> ATTACH LEGAL DESCRIPTIONS <br /> - ji; � f- L' '-` � f �=`�'`i�/A., <br /> PERMIT IS VALID FOR 120 DAYS �„ �, �I �� 1 f;..� j;'' ;-—��'c'�,�; <br /> (May be extended upon written approval from Public Works) � <br /> A NEW PERMIT IS REQUIRED IF WORK �� c, ��"-!: !{JI:r� L'����tj��"'U <br /> ' HAS NOT BEGUN WITHIN 60 DAYS � ��� <br /> �;;���r��� `- �`l.�, � rf .(_�� / ;f`.� <br /> ti <br /> THIS PERMIT TO BE POSTED ON JOB SITE. `�C�JI•%G tS:`� �("L /'%��»� 1J � �� f, <br /> ;� ! /i jc'1'///t:' i !J: `.'1(��/��' %i'-s /"'(ti�J �L%1 r I <br /> CALL FOR INSPECTION 259-8811 � ,; ; �� i ;'ir'//U /� r C �'/�� � 'K� ���f�I���� J <br /> 24 HOURS BEFORE BEGIiJNING OPERATION J <br /> ,�f � �i. — �� .! t' r ..'� � _ . . ' i' -} =t /l� —�� / �/..,. .. . 'r' • 1 <br /> t i�f:�i "? . ',(;.. /f . . > ' � - . . . . . <br /> / <br /> , .- ,-� z � t( � ,° ,� /� -��� r.,'4 <br /> <,/r.. � <_F"IJa- .ti. �E !i/t� �._ ; : ,' ::. . . <br /> The undersigned owner hereby agrees to hold and I <br /> F'� "'�'., -�` !� �- ��-% �_ � '-�` "�'��j' i save harmless the :ity of Everett from any and all <br /> -� claims for damages,costs,expenses,or causes of <br /> action that may arise because of the c�earing, � <br /> grubbing,grading,and/or excavation activities <br /> hereto applied for and further agrees to complV <br /> PLANNING/SEPA APPROVAL with all provisions of this permit. <br /> � <br /> Signature of Applicant/Date of Application <br /> y � �f <br /> ._. ,; J ,.; / ,' . , <br /> Address � <br /> / ' � � f <br /> / l �' ' % I <'�L•f_L: r _ <br /> .Approved for Construc[ion (PWI City Z�P <br /> .. . -_.. . . . , i <br /> Issued 181dg. D� � �Date Telephone Number Altemate <br /> � � B <br /> 5 <br /> Approve as Constructed (P 1 FEE <br /> I <br />