Laserfiche WebLink
��� <br />kJ � 5 <br />C H <br />> H f/� <br />H zn <br />y .�i <br />0 ".G � <br />";1 H'r <br />fA H <br />y r <br />�o� <br />H t7 <br />�ng <br />c� � o <br />H <br />ryz <br />HH <br />g� <br />H <br />C7 C7 � <br />��� <br />HO� <br />Date�� <br />i�pp�Ifd�1C(� . Of <br />PUBLIC WORK� PEf�MIT <br />Print or Type Only <br />' [ <br />�_��i��' 'Y(��' — <br />I p`y;ip� �J,3tling AtlOruss Ci�` <br />Apphcant Mailiny Atldress City Lp <br />� �n•nn Wor�s Pm�pj',y��y�]�� /��( �`��–({\f � <br />f-I�LI D��PI • —l..I �-- . � `�LJL/ <br />{'.i�1�L WOIkS { L•11 5 <br />ro:.,� ��P _ _--- <br />, :,���,,:�s------- <br />, , �.�. s — <br />Phone <br />Phonc <br />�escribe Proposed Wor« __� J1— Yi�. 1—��_ l.1 Q� � <br />Prolect Adtlress Id knowN <br />l.Ifach Inur �4) copiEs ol plan5 �or proposed work - Dra;. I:. so�4, nnA notq the tollowing as.lpp��caUie <br />• Proper�y LmeS • C�•nfi+rLr,e of S�rect <br />• Outline and dimens�ons of :�II e.isbnq o���t • Ind�c,�te Norlh <br />prOposetl Slructure5 on the I��I • Sn�.�p: �ny prppp5ed yiaAmy chanyas <br />• [�i5hnq and prJpOSCA uliLh��s • $htr.v mca5uremCniS <br />" PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in ativance • phone 259•8F310. <br />2. All worK shall he performed in accordanee wlth Ihis permit and current City of Eeerett Dz;�9n and Construclion <br />��"' � Standards and Specihcations. <br />o.. � 3. Call lowtion Underground Service aB hrs Lelore you tlig. TOLL FREE NUMBER 1-800-424•:i555. <br />�/a�1'lt`il �F'T 1"'�C�I1'�2J <br />s <br />��/'/' • _ <br />�nu�oved lor Construction Datr. <br />FINAL INSF'ECTION <br />Approved as Constructed <br />rvr�rlt PUBLICVlORKSDEPARTMFNT <br />� 3200 Ceda� Slreet <br />Eveietl. WA 9R201 <br />Phene:259�8810 <br />ACKNOIl�L[DGEL'ENT OP CONDITIONS <br />� <br />0 <br />Thu undcrsi9ned owner/�ppl;cant hcreby a9rees to hold antl save ham�� <br />less the Cdy ol Everett Irom any and all claims lor damages. custs. <br />eKpenses. or causes of adion Ihat may erise because ol ins�allation <br />and maintenancc ol the impwvement or olher ngh�-of�way use hereto <br />apphed lor and luriher a9rees to remove same upon nolice Irom the <br />City and �o replace nublic proprriy damac�eA Ihereby. <br />Si9naiwc ol APPhCan� Dole <br />WORN AUTHORIZED �V Th{IS P[RMIT MUST BE STARTED WITHIN <br />1B0 DAVS OF D�TE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERAIIT MAV BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PRUJECT OV[R �30 DAYS DURATION. <br />