Laserfiche WebLink
� � � <br /> A� x <br /> C Fi <br /> � Hxp� <br /> HZH <br /> �` y� �i 2.�3 - <br /> � H� Date ' R� P���,���o,�s P�,m,�. <br /> Cn ---7�-'�� ei,an o�oi .—�-11 ��1-�RG�- <br /> y Ar0licatlon For <br /> � � d PUBLIC WORKS PERMIT �°°'","°'""°° 5 --- <br /> totai Fco <br /> LessAppl Pce Pa�J S �---pD— <br /> � [�.] � o.,i,��P o�� S �i�--O � <br /> z �,.�� Print or Type Only T() pOSTING � �'z�"�— <br /> H <br /> � ~ y II� S�� D�' <br /> gNN �G)ntds��e �l�L�� nr' l�� �RrVSV� �T7 5 �.-.5�7/ <br /> n ty V� J MaiNn9 Address C�ti� Z P PI o e <br /> Owner <br /> �a � -y� <br /> yy C.1'�A)!1Pr Phonc <br /> y� � Applicant Mailinc�Address Ciry Zip <br /> Desc�ibe Proposed Work ^�P�:�f�1�-� � <br /> W <br /> Proiect Address 1�� known) ���C i14�nJ�r �• � <br /> �� <br /> Attach faur I�)copies ol plans foi proposed work� Draw to sr.ale and nole Ihe lollmving as applicable'. � <br /> • Property Lines • Centerline af street <br /> • Oullinc and dimensions ol all esis�in9 and • Indicate Morih <br /> proposed strucWres on Ihe�ol • Show any proposed 9radin9 changes <br /> • Eristing and pwposed uiilities • Show mensuremeMs /„ <br /> W <br /> '�1 DO NOT WRITE BELC V THIS LINE O <br /> 1�I PERMIT CONDITIONS � <br /> 1.All calls ler inspecGon shall 6e made 24 hrs.in advance-phone 259•8810. <br /> '�� 2.All work shall be pedormed in occordance with this permit and curmnt City of Everett Design and Construction <br /> Standards and Specilications. � <br /> ' ' 3.Call Localion Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800•424•5555. <br /> � J � <br /> t yC ^` O <br /> /• �-(.ptt;i N�Ck/✓ U' � LL (O �l2)/+Qc�./[ mC.lwf»GG.f�✓ //'O/r'7 <br /> ' UG't�4��-n 51 "�� sSa'.�U-�-L �7acm/- <br /> !/ 1 <br /> i/ <br /> �1 S /��.G..�� �a/ /�t�n �al.�� � 2 ')"*-�.�y,,rcn� � .3 �/�ct/� ♦^ <br /> r . �,�y� �„ of �is��a/�t.d� �° V♦ <br /> �� � �� � ��`�"_�' ���• iPor <. . <br /> _� �. Q � //�0 ��,C'�'��„ .�a ���•.�.��ao �rz, .�/„� � <br /> _I �"`d'� . � ;t�- ��� a <br /> ^ .Ga /2F�-N.t� ,Z�i� CO�'C''ic�cc.t`w6- .'�O �jtt��+✓,�i�►�✓ <br /> 1 � 7 .y� /�i°d-`.�x' '" Q[(/ <br /> i�/ . �(�� /f7��� Cr / C���'�,r,� •"� <br /> 1 ' ,i-� Z/�.C/ ���+'L� '✓'� � � w � ACKNOWLEDGLI.A[NTOfCONDITIONS <br /> � +� The underei9netl owner/apP�icant hcreUy a9rr.es to holA and save h:um� <br /> � — less ihe Ciry ol Everelt irom any and all claims for tlama9es, cosls. <br /> � ezpenses, or cnuses ol action that may anse because o� instaW�non <br /> ���3— �,��_y/ and maintenanca of the improvemenl or olher r19h4oI�waY ��y�' ���`�"In <br /> applied lor and lurlher a9rees to remove same upon nohcc Iroin Ilro <br /> Appr�r Cons ruction Date City and to replace pubhc property damaged thereby. <br /> / ii <br /> ` ,�/l/`��� �� � y�ii � w__ � � . l<�,c� � �16 /9i <br /> u� � <br /> FINii� INSPECTION� " ��1e ���� <br /> ,\pprovnd as Constructed <br /> Signature of Applicanl <br /> WORK �UTHORIZED BV THIS PERMIT MUST BE STARTED W�T <br /> 0 i,�i,�i.�� PUBLIC\NORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarStreet 8E DILIGENTLY PURSUEU i0 COMPLETION. THIS PERAIIT tdAY B[ <br /> Everett,WA 9B201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone�.25J�8�10 PROJECT OV[R 90 DAYS DURATION <br />