Laserfiche WebLink
-. <br />2/1/93 <br />Date <br />qpplication For <br />pUgL.IC WORKS PERMIT <br />I� Print or Type Only <br />I <br />IRichard A Sullivnn 4515 S,4th^��eressverett 982�-' <br />Same <br />Describe Proposed Work <br />GaraBe/ehon — <br />Prolect Address (if knownl <br />252-6620 <br />PuDlic Wodb Pe�mi� � _—�� <br />90/9a <br />Bltlp DeO�- • <br />PUELc Works Fee s --� <br />Tolnl Fee <br />less Poot Fee Pa�E s��� <br />9alance Due g —�'�- <br />Phone <br />ZiP Phone <br />qt�ach tour (4) �opies of plans lor proposed work - Draw lo swle and noie � Centerline ol siPeet able: <br />� Property Lines • Indicate North rading changes <br />� putline and dimensions of all existing and � Show any proposed g <br />� proposed str�clures onthelot � Show measuremenls <br />• Ezisting and P�oposed utilities <br />.... .�nr wai7F B[LJW THIS LINE <br />PERMIT CONDITIONS <br />t. AII calls for inspection shall be made 24 hrs. in advance • phone 259-881 . <br />2. All work shall be Pertormed in accordance with this permil TOLL FREE NUMBER 1t800'42'4'5555uction <br />Slandards end Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. <br />� <br />1•c9-9-� <br />C�ate <br />�• NpP�o��ecl lor Construction <br />� <br />Date I <br />FINAL INSPECTION <br />qpproved as Constructed <br />�pUOLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone�.259-6810 ._...__ .. _ <br />/f aG � <br />.�" ��. �e- <br />,�' `� ',�''' <br />1 !! � � �✓ . ee� <br />,G( � ,S'<c�/� `Lc�'' <br />�, +� �.W <br />��� � �, C'a,a-� ���1 <br />�� <br />Ui/x � � <br />��Q •� U�C. ���"�., <br />W <br />H <br />� <br />• ACKNOWLEDGEMENT OF CONDITIONS <br />The unde�signed owner/app���ant hereby agrees �o hold and save harm- <br />IQ penses, or causesr o'1 acl oo thal may lar se becau eaofa9 stallatson <br />yppl ed1for and further agreesVlo removelsame opon nol cesiromrlhe <br />City and to replace Public p�oPertY damaged lhereby. <br />i <br />Dale i <br />SignaWre ol Applicant <br />WORK AUTHORIZED DY THIS PERMIT MUST BE STARTED W�TH� I <br />BC- DI�LIGENOTLYDFUR UED OICOMPLE�TION.DTH SEPERMIT MAY BE <br />CANCELLED BY TH[ CITY UPON ANY STOPPAGF �F �� �R� ON THI� .I <br />PROJECT OVEIi 9�� DAYS DURATION. __ __ <br />• <br />