Laserfiche WebLink
l CLEARING, GRUBBING, GRADING, AND EXCAVATION PERMIT <br />� Type or print clearly in ink <br />• i r�tESS HARD - YOU ARE MAKING COPIES � <br />Public Works <br />Everett, Washington <br />APPLICANT (Undersigned) AND FIRM REPRESENTED, IF <br />go <br />PERMIT NO. y�3 <br />DAVE DAYIES <br />everett <br />. � <br />_� � <br />HEREBY APP�IES FOR PERMISSION TO (Identify Quantities) EXCAVATE & GRADE �OR EXTENSION TO EXISTIPIG UkIVE1�AY <br />�': Ai 111E FOL40WiN6 LOCATION (S) - i 41 o Muv � nt '^:: <br />Y • <br />DETAILED, SCALED DRAWING OF WORK TO BE DONE, ATTACH 4 COPIES <br />ATTACH LEGAL DES::RIPTIONS <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 PCRMIT TO BE POSTED ON JOB SITE. <br />CALL FOR INSPECTION 259-8811 <br />24 HOURS BEFORE BEGINNING OPERATIOi� <br />� <br />PLANNINC;/SEPA APPROVAL <br />.Y ' ;- <br />� -- <br />Approved foY Construction (PW) ' <br />Issued (Bldg. Dept) Date <br />Approved as Constructed (PW) <br />.�,,rtu�z� . <br />The ��dersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages, cosu, expenses, or cause: of <br />action that may arise because of Me clearing, ' <br />grubbing, grading, and/or excavation activitie: <br />he-eto applied for and further agrees to comply <br />wi:h all provjsions of this permit. <br />/� <br />�� %%!� �/� / �� <br />Signeturq.of ApplicandDate of Application <br />1410 MUKILTEO 80ULEVARG <br />Aadress <br />EVFRETT, ��IASIIIi�GTOiJ 98203 <br />Ciry Zip <br />(H) �52-2LG� (�I) 455-5�M126 <br />Telephone Number Alternate � <br />FEE <br />I <br />