Laserfiche WebLink
Date Z�18/94 u <br />Applicalion For <br />PUBLI�WORKS <br />� <br />� 3S Z� ^� <br />p�RM�T �r, s-z3� <br />� O O O � O <br />Print or Type Only � � j� �� o� Q <br />N � ir5 N M ;x <br />N' �� Mukil <br />21 qth Dr <br />A1 Jubie Construction \ Ma �Addre � <br />owner o � � � �� <br />S�e Mailing Address <br />qppllcenl <br />New house — Basic 227 <br />Describe ProPosed Work <br />8 00117 <br />C Q N <br />�,�j H <br />� M rTN <br />'�' �oo�a'� 990-1456 <br />aueiicwa��P°�43569 Ov� <br />aiaa. o.o�.• <br />Publk Wo�s F�� � -� <br />Tol�l Fse <br />Less R00� Fea P�•C S� '�� <br />BelenceU� u�-- <br />Zip <br />Lot 2 SP II30=89 <br />Project Address (it known) � licable: <br />1' ot streel <br />Attech four (4) copies of plens for proposed work • Draw to scale and note the following as apP <br />• Properry Lines <br />• Outline and dimensfons ot ell exi+,ting and <br />proposed structures on the lot <br />• Existing and proposed utllities <br />• Center ine <br />� Indicele Norih radin9 changes <br />• Show anY P�oposed g <br />• Show measuremenis <br />Phone <br />PERMIT CONDITIONS <br />�, q�� calla for Inspectbn shall be mede 24 hrs. in edvance • pho�e 259'�7 • <br />p. q�� V,rork shell be performed �n accordance with lhis permit end curtent Ciry of Everett Desi9^ 245555. �ion <br />Stendards end Spe��f�cationa <br />& Cell Localion Under9round Servlce 48 hra before you di4 TO�� FREE NUMBEH 1' aC rO� � 1 <br />� O� P.agGyy�Gylt '�Of' SidG SAV�-t' <br />�, mus�a� � tv �h�- �b�;a arorKs ��'�ment P^iori� <br />t of v�[or' 1� on Sid�sovP.✓' i-F s;� saw�' <br />C orn n►to'�GGmG►� <br />�hn`-1. u�►'+n� � ma,tn `�v► MuKtlt�ee� R�1vd, <br />Y/�/ / 1MG� � L �� <br />qpproved for Constr tion <br />�� ��'s' <br />Date <br />FINAL INSPECTION <br />ppproved as Conslructed <br />�PUBLIC WORKS DEPARTMENT <br />3200 Ceder Streel <br />Everet4 WA 98z01 <br />phone: 259•9810 <br />W <br />F- <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersig�ed owner/apPlicanl hereby agreesto hold and save costs, <br />less the City of Everett Irom any and all clefma for dameges. <br />and maintenance ot the improvement or other dghhof•weY use hereto <br />expenses, or causes ot ection that may arise beceuse ol installat on <br />applied tor and furtner agrees to remove s 1mer by^ ^otice irom the <br />City and to�f�e_P� �e �ublic n Perty S�3meq� �j y <br />11 // A ` A 1 h. �i <br />3i nature of A licant <br />WORK AUTH RIZED BY THIS PERMIT MUST BE STARTED W�THI <br />180 DAYS OF DATE PERMIT IS ISSU D AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PEAMIT MAY BE <br />PROJECT OVER 90 DAYS DURATION. STOPPAGE OF W�RK ON THIS <br />