Laserfiche WebLink
� <br /> Date � 85-/2/ <br /> Pu�lic Wort�Permn• <br /> Applicetlon For eiao.oeo�.• �.� �� <br /> PUBLIC WORKS PERMIT PubTol�FueF�� s <br /> Leet�oG�FM PeIU a <br /> Print or Type Only e�i�nceoue S Z���� <br /> /f[, 0 ,6- <br /> Boyden Realty, Inc. 1429 Broadway Everett 98201 252-1166 <br /> Owner Mailing Address City Zip Phone <br /> J 6 D Builders 1429 Broadway Eveiett 98201 252-1166 <br /> Applicent Mailing Add�ess City Zip Phone <br /> Describe Proposed Work New SinQle Familv Residence <br /> Project Address(if known) - � <br /> Attach four(4)copies ot plans for proposed work• Draw lo scale and note the follo�ving as applicable: � <br /> • Property linee • Cenlerline ol sireet � <br /> • Outline end dimensions of all ezisting and • �ndicale North <br /> proposed structures on the lot • Show any proposed grading changc s <br /> • Existing end proposed utilities • Shuw measurements <br /> DO N07 WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS O <br /> 1. All calls for inspection shall be made 24 hrs. in advance•phone 259•8815. <br /> 2. All work Shel�be performed in accordance with this permit and curreM City ol Everett Design and Construction ' <br /> StandarAn and Specificalions. <br /> 3. Call Location Underground Service q8 hrs. before you dig TOLL FREE NUMBER 1•800•424-$555. <br /> � <br /> O <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> – The andcr,lyned ownedapplicant hereby agrees to hold nnu save harm� <br /> less ihe Cily of Everett from any and all claims lor tlamages, cosis, <br /> ezpenses, or causes ol action that may arise hecause ol ins�allatio❑ <br /> ����_ y��.j_SS-- antl maintenance ot the impruvement or other righ�•obway use hereto <br /> ���Approved f6r Construction — applied for and fwther agrees to remove same upon notice irom the <br /> �,, ./J Date Ciry and�o replace public property damaged Ihereby. <br /> U�'�c ' —�—�G .�n�.0� c�i. .�� <br /> FINAL INSPECTION Date ,1=.��,s <br /> Approved as Constructed Signatdre ol Applicant Date <br /> everett PUBUC WORKS DEP4RTMENT WORK AU'(NORIZED BY THIS PERMIi MUST BE STARTED WITHIN <br /> � 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Eve�ett,WA g8201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone: 259•d815 CANCEILED BY TNE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />