Laserfiche WebLink
.� <br /> � ' Pu�Lc WarAs Parmil• �/ �� � <br /> Date_1�25/91 TO POSTING S' ZD-93 Bi0gDe01.• Q�/26anA <br /> Q, Application Por <br /> PU�LIC WORKS PERMIT Pu�LCWorksFea <br /> Total Feo `S <br /> � ,es5 AOP��Fee Pa�U S <br /> O 35��—� <br /> � O O O � g S g � Ba��nce0ue � <br /> Print or Type Onl� � <br /> ..i .MtMM M N�p � N�/7 '�d' <br /> .-� N � M M W N ti <br /> � m � � '.iSS-BB'i7 <br /> Ddmon Sy CitY Zip Phone <br /> OWf10f \,� N C] U N p p,} <br /> Mat 6] a 6� G 3'3 3C fllr•�~i U <br /> O <br /> AppliCant Mailing Address City Zip Phone <br /> Describe P�oPosed Work Con t <br /> z W <br /> }7�2�7�E. Marine View Dr. � <br /> Prolect Address(if known) <br /> � <br /> Attach four(4)copies of plans lor proposed work- Draw to scale and note the following as applicable: � . <br /> • Property Lines • Centerline of street <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the lot • Show ami proposed grading changes <br /> . • Existing and proposed utilities • Show measurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS � <br /> 1.All calls for inspeclion shall be made 24 hrs.in advance�phone 259•8810. <br /> � � 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifi�ations. � <br /> 3.Call Location Underground Service 48 hrs.betore you dig.TOLL FREE NUMBER 1-800-424•5555. <br /> [� �v�a-ls�Gf' ,S��Cc�.;.� Q.Z�G���C;E�a-l^'A C',cc� <a(�cm� O <br /> (/ U <br /> ��,�, ���� dz, ���.t�� , #303 � <br /> S. �fi�or�x, �iCi� �.P.u.� R.o,Lcl. P�v �t� .ffia..��+� <br /> apo�c� .,�:o /�'�o�';v" �teo�v p�o�v.�atJ. ,�i��ul. , � <br /> 0 �� /� ,, �/f <br /> (O t�'/w-�aX! S//¢u'`vr' ?r�.•rr_�1v .�C �'"`�..£�¢tt,u�✓ 7na��v C/?ns�Ne-1°""'" .Gi� O <br /> Gn+-e� Co7•>�ru-c-t�Xo .l.t` W:.� Q. lo �� Dia. �-e6�'afs.cVLJ . <br /> 2QQ�� �i ' �e /JOC,� <br /> 2 n � /, '/ <br /> 7. TG�t�/� C� �O �E'�LlXA'�VLl�/ C�d�a�� (IZ /nGez . O��Y 7 �r7�� <br /> � <br /> �, " ' Cor.chv�. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ThE undersigned owner/applicant hereby agrees to hold and save harm• <br /> less the City of Everett irom any and all claims for damages, costs, <br /> ezpenses, or causes of action thal may arise because of installation <br /> and maintenance of the improvement or other right•ol�way use hereto <br /> ��/�j'���y+`i-j a/7�9� applied for and Wrther a9rees to remove same upon notice from the <br /> Approved lor Construc iot� Date -City and to rePlace Public ProPerry d ma9ed therebY. <br /> � ; ,,,_- s/�o •�3 '� , � �{ ti 1 <br /> FINAL INSPECTION Date Date <br /> \pproved as Constructed <br /> Signature ol Applicant <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHI <br /> evere[t PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREA�TFR IS TO <br /> � 3200CedarStreet BE DILIGENTLY PURSUED TO COMPLETtON. THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF�ORK ON THIS <br /> Phone:259•8810 PROJECT OVER 90 DAYS DUFATION. <br />