Laserfiche WebLink
C�� <br />TYPE OR PRINT ONLY <br />"��icalion For <br />PUBLIC V�►JRKS PEfiMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everetl. WA 98201 259-BN10 <br />oate "�` 5/8/97 <br />F "ic Works Permit M <br />Building Permit k _�SA�+� <br />Public Works Fee $ <br />B City 7ip Phone <br />Owner Mailing Address <br />rnona <br />Describe Proposed Work <br />PROJECT AUDRESS (if known) . so�' �AKF=- A"F — <br />Atlac�i four (4) copies of plans tor pinpos�d work - Drew to scele and note the tollowing if applicable: <br />"Property Lines "Outline and dim�+nsions of all exicting and ?roposed structures on the lot •Existing and Froposed ulilities <br />•Cxnterline oi sireet •Indicat3 NoAh •Show any proposed grading changes •Sho�v measuremenis-- <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMl3ER 1-800-424-5555. <br />���, �� ���t � �- ����..� �. <br />�� <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />W <br />� <br />�♦A <br />V♦ <br />v/ <br />O <br />a <br />ACKNOWLEDCEMENT OF CONDITIONS <br />The undersigned ownedapplicant hereby agrees to hold and save hartnless <br />the City of Everett trom any and all claims for damages, cosls, expenses, or <br />causes of action that may arise because of installation and maintenance of <br />the improvemenl or other right-of-way use hereto applied for and further agrees <br />to remove same upon notice trom the Ciry and to replace public property <br />damaged thereby. <br />Signature ot Applicant Date <br />�pMpLEi ON.RTIiIS PERMIT MAY 8E CANCEBLED BY THE CINIUPON ANY STOPPAGE OF WORK ON T}IIS PROJEC O EER 90 DA SEDUIR TEON`Y PURSUED TO <br />