Laserfiche WebLink
Date /��s/6B � P�o�,�wo�..P.,m,. �— y23 <br /> / RVP���Blion For N eiea o.o�• <br /> PUBLIC WORKS �ERMIT °�°.o:�«;"° . -- <br /> �.+s�co�rs.a.a S <br /> � g 8 S u�imcno�. f ��� <br /> Print or Type Only ,., � o� <br /> �V M M M <br /> � <br /> ��•ca�t�krn/�K— c:B . sa � �X 4oa�9 b��d�c w�l 2-i3zC, <br /> Owner MdilmS Adtl�eA '���f!f�ty Zio Phone <br /> i�; s <br /> �Y'dl.-.-..�sf� �"r�t <br /> o as <br /> APPI¢ant A1mIin9AG0ie55 Gty Lp P�one <br /> Describu Roposed WorM F�M1^�V� �Pn,�_�F y�A S4 Crr�J7U L� s I '� '-IR� <br /> RT' fi( r �✓»�ft� -ra c-!�w�G� B✓Y .. <br /> cS/OdCJ.PLK T 6'� C�a.rro ,9a ,�r 2 v� S. <br /> W <br /> Proiecl Atltlress pf knownl 'f��/� �A��S 'Qv'�. � <br /> Allach lom�A�co0�es o�0����la�pioposeJ woeh�Draw ta scale ana nole Ihe lollnwing aa apphwble�. � <br /> • PioPerty Lmes •Cenieelme a�slreel �A <br /> •Ouihne anE dimensions al all e•�sling antl •Indicate Norl� V� <br /> proposep SImCIurCs on I�e lot •Show any pmposetl gratlind c�anges <br /> • Eusting and proposed utilities •Show measmements � <br /> DO NOT Wfil7E BELOW TMIS LINE O <br /> PEflM1T CONDITIONS <br /> t.nu caus lor insoection shau be made 2a nrs.in etleance�phone 259•8810. ^ <br /> 2.All wod shall be pedormed in accortlance with I�is permil nnE cwrent Cily ol Everell Dosign and Consimtlion � <br /> $1.ntlaitls ene Specilicalions. <br /> 3.Ca11LocationUndergrountl5ervite�lBhrs.beloreyoutlig.TOLLPHEENUMBERI-800-024•5555. � <br /> � �'jIGG,� o{F ,�A.e,e�,uc- SP.oG�s �N �o•✓T oF O <br /> �SiO� U//�t.e' To pr� �P�ii,o�xo i9.✓O �c'uviz' � <br /> �9'ff�� f'�=�7GJTRio.t/1 Aia'�UU/�.!] TNROdG!/ <br /> P/l,e,Ei.✓� /l.eE9. N <br /> �j JN.ST9�G SiDd'[✓.vG�C i�`.e Ci,-y STA.vp?,•ev '3n6 O <br /> (AlT/-�c.�coJ Q. <br /> ACKNOWL[DGEMENT OF CONDITIONS <br /> T�e untle�signed ownevanpi�canl he�eby ag�ees to hold nnd save narm� <br /> les� Ihe Cily ol Eveieit Imm any and all claims lor tlnma�es, cosls. <br /> enpenses. or wuses of acLon I�al may anse bewuse ol mstallnt�on <br /> ��� i / nnC mamienan[e ol Ihe�mpmvemenl or oihcr nnh��obway use�erelo <br /> �- appLetl lor ana lurinm '+g�ees to�emovr aame upo� cnhce Imm I�e <br /> %�nmm�etl lor Constmr. Date Ci1y ana to�e0lace�ubLc�:^nm damaqetl themEy <br /> / <br /> .._..Fr o �+" P� <br /> FlNAL INSPECiION Ddle <br /> Anp�ovetla5Lon5!�uctetl Sig aWreo�Appl¢an� a�e <br /> �•���i���� PUBIIC WORKSDEPARTMENT WORK AUTNORIZED BV THIS PEflM1T MUST BE STARTED V:�TNIN <br /> � 8200Ce0nr51ieat 1B0 DAYS OF OATE PERMIT IS ISSUED AND tHEREPFTER IS TO <br /> E�eroll WA 9B201 BE DILIGENTLY PUHSUED TO COMPLETION.THIS PERId1T MAY BE <br /> CANCELLED BY THE CI7V UPON ANY SiOFPAGE OF WORK ON THIS <br /> P�ano.259�8810 PROJECT OV[R 90 OAYS DURATION. <br />