Laserfiche WebLink
-� <br /> _ . - < �;i= �o � <br /> - , Puonc Wo�Fs vurm�/n/•� �� <br /> � � ��� �� � ��t p/�. �Jn��� �ry� Dia9 �e0t �—I-I� <br /> Dale— ., <br /> .1GU�����ion For ) _ --- <br /> PaoTo�lfrn�Ce S - <br /> �r� FUgL.�t; '�1(ORKS PERMIT <br /> � <br /> �<=,A�.� �P,.�.,,� S— --- — <br /> �a y a��,��.o„� 5 =_ _ - --__ — <br /> y y y Print or Typ� Only <br /> rx % <br /> r-� 9 s . ��/ � / ,' �I �i- � , i - <br /> � x� �I ���� .-. ,'� (� � �� � �.-�� �"� � � L I 1�� Z� Fhnnc _--" <br /> H� �!-_f.-��l - I.fail�n9Atld�__ CitY .. <br /> � H� 'Dwner �/� \ ! _ �� � . _ <br /> [n r <br /> y C' — � Phone <br /> � Z 3 C�IY Z�p <br /> p�z� 1.1aiPng Address <br /> APPlican� ' ) ' -�./ <br /> HC7 / ���/y .. '._ <br /> � �8 <br /> -=��-i2 ( k��- ��! �:1lC. -. -- <br /> n„ n Describe ProPo=ed Worh _ <br /> r ~� —__ � <br /> z <br /> ti H <br /> H <br /> n t7 v: � �,Z 1_ - L r� �� Di7 �F - - ---- <br /> � �� Proiect Address 01 knownl — �� <br /> y y C/) AllaCh�our(dl Copies o� Plans�or Proposed wo�k-Draw to sr.alc antl nNr�eC�oliowln9 o'SiPPC�t 3���•' I— <br /> H O CA � nroperty Unes • Inn�rate Nw�h � <br /> • �Iltlln¢80(�dRfICO510n5 01:111 l'��S�inQ:Ind • Sh:�Y: 1�1Y i;rOppL.Crf q�dtL�,q �:�-�;tn�:� _ <br /> propoSCd 51rUCIUleS ort�hQ I0� � �,-p;� �i��,�yprm[�n�ti M <br /> • E.is�m9 anA proposed u���d�es W <br /> 0o rinr �vui�e eei���:� ��+is�w� � <br /> PERId17 CONDITIONS 2$9�8810. � <br /> .�� 1.All ca1151or inspection shai��e ma Je 2�1 brs �n,Jv.u��'�" ���'II""' <br /> � � 2.All H�ork shall be pedD�metl lo ae�ordnnce wilh ihis pen^�i�+�';��-��'renl Gdy o�Eeeiolt De�,i9n anA Consliuctio�� <br /> Slandar05 antl Sn"cil�calions. � <br /> 3.Gatl Localion Undergrountl Service 48 hrs.belore you�1�q TOLL FREE NUMBER 1•600�424-5555. <br /> �� ! O <br /> '^� , i � �r � ' �`I I'I' MU��1� ' <br /> t . ;.r.�y ��HAl:f;l� � F� 'iilF{ f }?1 T41A'� ' <br /> PY 'I'NE YUP1�I�' kil(:KS TNSPF��TOF.. � � <br /> "'"') �, . �;���NNF.CT DOtJA7SPOn'p5 TO PURT,IC URAINAGIs l.'�'� <br /> ' '� �,. IiI�,F.P r.TTY STRF.PTS CLL'nN 1T ALi, TiMTS. /A <br /> :�t]Y IiAM�GT: T� TFIE i'(1RH ANI� �1DFWAI,K 41Tii� : � O <br /> � i tI, r, rl , . . •�1-t� �il ��,1: �i �,,.� i.r�,.� i � lq��i+r � , � <br /> � '��� a. <br /> � �; <br /> AGKNOWLFOGLM1IC^'�OP CONDI110NS <br /> 6'� � � The unde�si9��ed owner/aPPliCanl here6Y�9rees lo hold and';a�'e 1':"°* <br /> ���� Ie55 the CiIY ol EVetolt Irom any and all clotm5 lor Cainngus. costs. <br /> enpenses. or causes o� aclion Iha� may anse Uecause o� installaUo�� <br /> anA mainie�ance o' ihe improvemenl or elhCt ti9h�-ot���aY use heielo <br /> ' � ,. � •�l � ` K'c>C� �'1 ' %(J aPPIn�J lor and luithei a9rees lo �einove same uPon notice I�om Ihc <br /> ( C,� '�--- Daie CdY ond to�eP1aCe UUUIiC ProPerry damaged�hCrehY. <br /> qpproved Ior CO��siruC � n � <br /> `,� / ,e-��- �.� ('� �-_ 3_ -?S `�'_ <br /> v �"-d`-----�""'__ o.,i�, <br /> Da1• <br /> FW�L INSPECTION Sig etuic ol ApPlicant <br /> qpproveAasConstrucicd WORK AUTHORIZED 13Y iH15 PERMIT MUST BE STARiED WITHIN <br /> C�i�i,��q� PUBLICWORICSDEPARTMENT :80 ��YS O� ���T[ PERh11T IS �SSUED AND THER=�FTEf7 i5 1(� <br /> 9200 Ced�r Sbccl �E DILIGENTLY PUASUED 1O COMPLETION THIS P[R�llT I1�V B[ <br /> Iyc�r�L l':A t47:�1 GANC[Ll ED RV THE I:ITY UP^N�NY STOPPAGE OF WO��K ON 11fi5 <br /> �i .. ;�,.,�.�;�t',� 1 NOJI.CT OV[H PO D,1V6 D11��411ON. <br /> n <br />