Laserfiche WebLink
Date '�/ `'„ ���,��,�w�,,.,��,�,�, _ <br /> `/=�3 ii <br /> n�na oon� • <br /> Applicahon Por - <br /> PUBLIC WORKS PERMIT �°"��W°,�.°°° <br /> ,,,�.��.� s <br /> tnSSA�qI GeePu� s _ <br /> Je�- on <br /> 6_'•^_eDoe s -1G� <br /> Print or Type Only <br /> T�l? !'JOC'in �o. /,'/i. /�'nX J'i�•i' /�i�� �i!_'i. .��.�f1lC l[�n i i/.�, � r�G�n '_�iG.:? <br /> Owner Mailing AtlAress C�ty 2ip Phone Len A <br /> ` `i .o�� <br /> Applicanl Mailing Address C��y Zip Phonc <br /> , <br /> Uescnhe ProPosed Wo�k <<E`fi'i� � £rUS�v�-• �:Oi� fi'c�C �,�^ i�n/—i/�._______,__ <br /> f�)�-.fi�,o lt,t �X�-�a��tio/7 . _- _- —_ —__.._ <br /> W <br /> Pro�ect Address(if known� '��nn-3 U-'� ����"'�'• '�� tin�->'� /�nr.�i.� �of � <br /> Atinch lour IAI copies of plans lor proFosed work� Draw to scaie antl no�e Ihe lollowing as appGceble: � <br /> • ProperlY LineS • Genterline ol slreel � <br /> • Outline end dimensions of all ezisting and • Indicate North <br /> p�oposed slruc�we5 on Ihe lo� • Show eny proPoseA grading change.s <br /> • Ezistiny and proposed uliliM1r.s • Show measuremenls �A <br /> W <br /> DO NOT WRITE BELOW TI115 LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for Inspection shnll be made 24 hrs.in edvence-phone 259•8810. � <br /> 2.All work shall be pedormed in eccordence wilh ihis permil and wrren�Ci1y ol Everelt Design and Construction <br /> Standards and Specilicalions. <br /> 3.Call Location Underground Service 4B hrs.belore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> �! ���/'Jf 7`u �c"' d i� /-�C/'��4n S 4�iroK'c� �/f/ �/��' O <br /> Z G�,_"/"G7� ����iG GG�'i�S CY��f On 9 f�'P"�', ✓ <br /> ' fhe ,a..ves� /�-i�. ���.-.ql ���.,� � <br /> S bOc.,� S/,uCl n-in•f�' � �� � <br /> fhe y«� �reCS /n f/�S 4�2'<< O��•L��LP fa a lr�edicn� O <br /> pr� edu���f.onn � /�Sl.t�ifirn u•���ry"4�Ci�,� �"etc�nrY�, pn , `. '. <br /> ,,, , a <br /> YCCdS 45 �';:gd��eo� b�/ �/,e F/.S. �� <br /> �� i � <br /> , � <br /> � , .�.�:�.. <br /> ��r�;' 3�/�„3//S.31 -• /l0�'— �\ + � <br /> ���'r. ACKNOVI(L OGEFIENT OF CONDIT�ONS <br /> �-D? - :i 21_�/C/.3�'3/- 22� , . . <br /> The undersignetl owner/applicanl he�eby 89�pe5 to Bold nnd save hn�m� <br /> -- -----"- less Ihe Gty ol Everetl Irom any and ull 4lalms �or Aamages, cosls <br /> / �� i � eKuenses, or causes ol nction ihnl,'may•a�ise hecausa o� inslallation <br /> % ,�. _ 5! y anA maintenance ol the improvemeh!or other rlghhof�way use hereto <br /> � � apphed lur and lurthei 2greC5 �o remove SAme upon nOtiCe IrOm Ihc <br /> qpp , r Cop elio � a Dale ��ty�i�� to replac puhhc pwUe��Y�amegeA �hereby. <br /> i' <br /> � / < �,^7 �i� � i ���' y O <br /> FI L INSPECTI Dale �� ' /`�/'�?� <br /> ApP'oved as ConsVucted Signnture ol Applicant Dale <br /> �"� PUBLICWORKSDEPARTMENT WORK AUTIiORIZED BV THIS PERMI7 MUST BE STARTED WITHIN <br /> 'V� 3200Cedar5lreet 1B0 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Eveiett.WA98201 BE OILIGENiLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> CANC[LLED BV THE CITV UPON ANV STOPPAGE OF WORK ON TMIS <br /> Phnnn 259-8d10 PROJ[CT OVER 90 DAVS DUPATION. <br />