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i <br /> I CLEARING, GRUBBING, GRADING,AND EXCAVATION PERMIT ! <br /> everett � <br /> Typa ar print clearly in ink � <br /> I PRESS HARD-YOU ARE MAKING COPIES � <br /> ' i � <br /> � <br /> � � <br /> iPublic Works PERMIT NO. ~� � <br /> Everett,Washington I / /� 7/ / <br /> � /, ' / I <br /> IJ T l l� Y O$ 1 6 t 5 !U L��D ✓� / /1 [, � <br /> i APPLICANT(Undersigned)AND FIRM REPRESENTED,IF ANY:.Y � <br /> � z7 � C� /v /- �� r1. 1'�JCP /�PJ�yPc1 � L(ld5li ��' OOS <br /> I / -F <br /> �i HEREBY APPLIES FOR PERMISSION TO(Identify Quantities) � ��� '� I' 1 �` d d P ! r % �` <br /> ' +l� �, >r' .:•i� <br /> � � +' <br /> p�lOt ATf11RfOL�,OWING LOCATION p) ,, 1 :` � , <br /> � �` � � � . *��r, �.r. , <br /> wn.r. <br /> ' � DETAILED,SCALED ORAWING OF WORK TO BE DONE,ATTACH 4 COPIES <br /> � ATTACH LEGAL DESCRIPTIONS <br /> i <br /> � PERMIT IS VALID FOR 120 DAYS <br /> ' (May be extended upon written approval from Public Works) <br /> A NEW PERMIT IS REQUIRED IF WORK � <br /> HAS NOT BEGUN WITHIN 60 DAYS � <br /> � THIS PERMIT TO BE POSTED ON JOB SITE. <br /> I. <br /> � CALL FOR INSPECTION 259�8811 � <br /> � 24 HOURS BEFORE BEGINNING OPERATION <br /> i i <br /> t <br /> I <br /> , The undersigned owner hereby agrees to hold and ; <br /> save harmless the City of Everett from eny and all I <br /> ' claims for damages,costs,expenses,or causes of i <br /> � action that may arise because of the clearing, i <br /> i grubbing,grading,and/or excavation activities , <br /> � hereto applied for and further agrees to comply �. <br /> pLAidNING/SEPA APPROVAL with all provisions of this permit. . <br /> =.�.�' �� ��1���� �'1 <br /> Signature of Appiicant/Date.6f Applmation <br /> � .• : � n �l/ (_ /n �� �%:, � <br /> Aaaress <br /> � .i . - .7'-- ,� ��� ��' /� e/ c P �U �� �.� . �� � � . <br /> . . :�._,•� .�_i . <br /> qpproved foi Construction(PW) � � Ciry Z�P <br /> �„•3 - � i�l� <br /> Issued (Bldg.Dept1 <br /> Date Telephone Number Alternate <br /> � on.,� .�_� �l y�� i <br /> � Approved as Cons cted ( FEE <br /> � _-. <br /> • '_ <br />