Laserfiche WebLink
�ate�_.= l�-� <br />Applica�ion For <br />P�BLIC WORKS PERMIT <br />c.� <br />Print or Type Only <br />�„��,� �vo„s P�,m, . _ys/42o _ <br />B�n9 Dco�. + _/ __ _ _ <br />PubM1C WO�YS F'0 <br />in�01 Cpp .S _ <br />Le55 A�l)I FCe� Gaet 5 <br />eri,��,. o��� S �B �5 <br />r_r <br />�'��.� <br />APPlicant P7s�h,�r.; �ddre<5 --__-- n�,. _ —__�.� —_.— .,. —' ____ <br />. � <br />Describe Pro�oe.ed Work ?VOS,�_�oy?ie __A.�_�,Tr _ <br />Lose�!�G2i e�.t_ <br />SNdG�LuiS1.. ��1✓t✓ ,��.�JW C•Q.F. fr �T ` �L .fX.� <br />__1 r— r �/�� -.- -y-- / <br />_UNjJ�%�A�Q1� �-�d-�1-,4��__���/1�_-T�D_�._/^rt�!�S__—��s_�/�M <br />Project Address bl kno�+�n; ,}i. w�y1 r ��� �� <br />'�-. -- �— ,--�/TS��1 ��il.l -------- �U. /YI AY <br />ZCD -W.M�/J�. <br />AttaCh lour (4) cpPics ol Plans to� proP�sed wo:k � Dra�•: to .r.ii�..c,,r notr Ih,� ;�quwinc a•� 7 I bl-�� <br />- � .I � , DU iC.l l. <br />� Proneny Lines <br />• OuOine and dimensions ol all exiyhng and <br />proposed slructures on ihe lot <br />• Exisfinn and proposed u�illties <br />"—�—���s <br />�. <br />• Cunterline nf street <br />• Indicate No�th <br />f Show any r.roposed ��atlinn changes <br />• Sho�v measurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance • phone 259•8810. <br />2. All work shall be pertormed in accordance wilh this permit and current City of Everett Design and Consiruction <br />Standards and Specificalions. <br />3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-$00•Q24•5555. <br />5`; �/Or,F .2'�0 � �He �0��-- �l4"S ���oro��c� or, 8�7�9�s <br />��y ��) <br />.s ye�� �, y s�r��� c���� af oLC f«� <br />- _. _... _ . _" _—_ I <br />._ � � _ / <br />> , cY//J��S � <br />A roved �rConstr on �pji��, <br />�� / '� r /`'f � <br />F�NAL INSPECTION p���� ( <br />Approved as Cc,islr�cted <br />����PUBIICWORKSDEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phonc:255�BB10 <br />W <br />H <br />� <br />� <br />� <br />O <br />� <br />� <br />� <br />a <br />ACKNOWLEDGEMENT OFCONDITIONS <br />l he unda�si�ned owneUapphc3ntHi�reby i�grees�to hold antl s.�ve hurm- <br />lv�;s ;h�: City o� Evarett Irom any and iil claims for camaqes, cosls. <br />CM�)1?Ii5B5. 0� CdIIGC$ Oi BC�1011 }h]I 013y 2lIS" V�CdUSE Oi Ifi51BI11I10�1 <br />and maintenance n! Ihe iniprovement or other iiqhl-of�way use he�eto <br />,i^�,i�n;; fer and further aq�ees to remove same upon notice Irom �he <br />C�:c ,i�;rf tn repiac�� U��blic property damaged Ihereh)'. <br />aa <br />Da�e <br />l"JORK AUTHORIZED BY THIS PEF�Iv1� MUST BE STARTED WITHIN <br />t8p DAYS OF DATE PERtd1T IS ISSUED AND THEREAFTER IS TO <br />BE DILIG6NTLY PURSUED 'O COAIPLETION. THIS PERMI7� MAY BE <br />C.ANC[LLEU BY THE GTV UPON ANY S70PPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAVS DURATION. <br />