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2821 PACIFIC AVE 2018-01-01 MF Import
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2821 PACIFIC AVE 2018-01-01 MF Import
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Last modified
12/19/2018 10:37:40 AM
Creation date
2/25/2017 7:18:09 AM
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Template:
Address Document
Street Name
PACIFIC AVE
Street Number
2821
Imported From Microfiche
Yes
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� <br /> � AP�LICAT{ON FOR PUBLIC WORKS F'ERMIT <br /> iyoe or o������ead�w�m mk 3 S <br /> PRESS HARD•YOU ARE MAKING COPIES pERM1T NO. $� <br /> PUBLIC WORKS 82/11228 " <br /> EVERETT,WASHINGTON 11/10/82 BLDG. DEPT. NO. <br /> ❑ OWNER �AGENT DATE -_ _..-_-- -- - <br /> Cobra Construr,tion Co. <br /> APPLICANT/FIRM REPRESENTED __ __ _ --- - -- — <br /> ADDRESS P•0. Box 129� CITY Everett _TELEPHONE .Z58-3667 <br /> Site Development <br /> HEREBY APPLIES FOR PERMISSION TO — --- '— <br /> z <br /> _ o <br /> -- ----_. _ 'i <br /> � �_a � , CZC � IC. �e. c' <br /> AT THE FOLLOWING LOCATIO,+ m <br /> Attach five(5)copies of preliminary plans tor proposed work.Draw to scale and show the following as applicable: M <br /> —1 T <br /> • Property linas and strest identity. ' Topographic changes requiring cuts and fills .. � <br /> ' Outline and dimensions o( existing and other than normal toundation. `" m <br /> proposed structures. ` O ite drainage systems when required. m o <br /> • Existing and proposed utilities. • E o ion control methods when required. c-, <br /> ' Gen'terline of abutting right of way. • N h arrow o m <br /> _ _ <br /> m <br /> Signat Olicant ^" <br /> .O 2 <br /> coNoirioNs: PUBLIC WO PE T � � <br /> —1 N <br /> < <br /> T <br /> O A <br /> T � <br /> -i m <br /> x <br /> m � <br /> \ N <br /> c imi+ <br /> � <br /> z c� <br /> i � � i.. ; .im <br /> �l � ,. n <br /> _ # a `-�- � <br /> � <br /> _ <br /> A <br /> 2 <br /> --1 <br /> 2 <br /> r <br /> N <br /> Z <br /> O <br /> �-i <br /> ("� <br /> m <br /> The untlers�dned oN�nei hereby egrees to �ola e�d save harmlesa <br /> Mc City o1 Everett vom nny enn au cloims for dame0es, co'is. <br /> e�Denses,or causes ol ection Ihat mey arise bece�se of Inelelletfon <br /> and maintenence ol t�e imDrovement or otRer righ�•ol�wey uee <br /> hereto epp�ied�or and lurther eBreea lo remove sema�pon notice <br /> from the Ciry antl to re0lace public proGerty tlemegeA 1heroDy. <br /> APPROVED FOF CONSTRUCTION DATE ACKNOWLEDGEMENT OF GONDITIONS ' <br /> APPROVEDASCQNSTRUC?ED DATE SIGNATUREOFAPPLIGANT DAIE <br /> PERMIT IS YALID FOR 1 YEAR CALL FOR lNSPECTION <br /> POST ON 259•8811 <br /> ExPIRATION JOBSITE 24HRS. BEFORE�ONSTRUCTIAN <br />
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