Laserfiche WebLink
; <br /> � y ��', G�y� ..r_ • � _ .�. .._ . .. -�. .. ..� -- ._._.-�---- --�-- —�--- ��— <br /> ,�,� H m <br /> y �� Date '� � PUELCWo�ASPer �. �/`q <br /> FC H� e�aa oeni..� Ll�/ � <br /> Application Fo� <br />�i �y� PUBLIC WORKS PERMIT — <br /> PunM1c warxs Fec <br /> y � loiniFee S <br /> �i Lets APpI.Feo PaN S_ <br /> p�d Prinl or Type Only o��,�«o�� a <br /> ��g ,� , ,.! /L�LLf�)Ct,Y.�,�, % .C1t',l�jl� �7��G� 25�-07/�-�/ <br /> y� G�7 , 1. /i-rlr'1 � <br /> .�y O ner�� Mailing Address City Zip Phone <br /> M <br /> �A <br /> ��y li��, »n�v <br /> Appliwnl Mailin9l�dtlress City 2ip Phone <br /> y� 1 / � t ) )� � �: ,1 <br /> ON DeScribePwposedWork ���y� � '���rl�� �Jl�� -�-�_� — <br /> �� i <br /> Projacl Atldress lil knownl �1�—�— — � <br /> Atta[h four 141 toDies ol plans lor proposed work- Draw to scale and note ttre lollowinc�as apphcat�le: �� <br /> '� • Properry Lines • Centerlme ol street /A <br /> • OuUine and dimensions ol all e*islin9 2ntl • Indicate Norlh V� <br /> proposed s�rucNres on Ihe lol • Show any proposed 9radin9 changes <br /> � • Ezislin9 anA proposed utilitics • Show measurements � <br /> � DO NOT WRITE BELOW THIS LINE O <br /> '�' PERMIT CONDITIONS <br /> t.All calls tor inspection shall be made 24 hrs.in advance-phone 259•$810. � <br /> ' ' 2.All work shall be pedormed in accordanca with this permit und current City ol Everett Design antl Consiruction <br /> � Standards and Specilications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800•424•55b5. � <br /> '' I � ,. '� .. t f r•�`.,' .;..l,<,.w.. ./ O <br /> ' �/.C?l.co LvGt/ :i �= ` <br /> ii / % -/'�'�`' �I <br /> ' /K� Fl �Y�..�• _�.i � <br /> + _'_.. <br /> � a <br /> _� <br /> �' � ACKNOWLE�GEMENi OF CONDITIONS . �� <br /> �1 The undersi9netl ownedapplicant hereby agrees to hold and save har.m <br /> 1� . less Ihe Cily of Everett Irom any and 'all claims lor dama9es, r,osls. <br /> expenses, or causes o� action iha� may anse because of instzllatiun <br /> � and maintenance ol the improvement or other rightol�way use hercio <br /> �-. applied for �nd furiher ac�rees lo remove same upon notice Irom the <br /> Approved loi Construc�ion ����� City and to replace public properry dama9eA Ihereby. <br /> FlNAL INSPECTION �a�` <br /> � Appioved as ConsVucted Si9nature of Applican� ���� <br /> WORK AUTIiC�R12ED BY THIS PERMIT MUST BE STARTED WITh{IN <br /> � ��p�i.�� PUBLICWORKSDEPARTtdENT 180 DAYS OF DAT[ PERMIT IS ISSUED AND THEREAfTER IS TO . <br /> � 3200CeAarSireet BE DILIGENTLY PURSU[D TO COMPLETION. THIS PERMIT MAY BE <br /> Everett,WA 90201 CANCFIIED BV THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�881C PROJECT OVER 90 DAYS DURATION. <br />