Laserfiche WebLink
� P�iP,,.�1Yrn. P�.��.��i a /� %��� � <br /> i);�Ic_�-�-9� 35852 — <br /> ^ � � -- emo oeo�.. .-- <br /> "� Application For <br /> �y � � PUB�IC `dVURKS PERNGIT `°";o,rFee`�—$ --_ <br /> Ly H N __ <br /> M � � �rse noo�F�r r,�n S.. <br /> ��.i� <br /> y Z �� rn nntTlNf, 5 -z o����«o�e s-= - <br /> � y a Print or Type Only J1� <br /> oso <br /> � Vf M <br /> � � �v licam Construction 3514 Broadway Everett *�A 9820' _ :58-4331 __ <br /> M � O Owner . Mailing AtldreSs CiIY Zip Phone <br /> L7 . f1 � . � �♦ <br /> OWt1Ci � <br /> .�'., M � Applicant Mailin9 Address Giry ZiP Phone I ( _ ��+ <br /> � �.r� <br /> C N <br /> .+ �av� E��/ <br /> � ° �' Descdee Proposed Work new SFR Lo[ 3 5 -- <br /> � � � — <br /> 2 H tn <br /> H O tn <br /> _ � <br /> r� ,i�.0 nddress 1��kno�.nl Z g'� � U I �\VC�EST �V� _ — � <br /> �U��ch lour 141 copies el plans lor proposed work•Draw to scale antl note the lollo�vin�i as applicable: o� <br /> • Properly Lines • Centerline of slraet `� <br /> • Outline and dimensions o�all caistinq and • Indicatc Norih <br /> proposed slmclures on ihe tot • Show any proposed qraAin9 changes <br /> • Exishng and propesetl uliliiies • Snew measureme�ts �� <br /> DO NOT'idR1T�BELOW THIS LINfE �` <br /> PERAl1T CONOITIONS � <br /> i � 1.All calls lor inspeclion shall be made 24 hrs.in ad�ance�phone 259•881 O. �y <br /> I ��' � 2 All work shall be pedormed in accordance wilh this permit and currenl Ciry nf Everet(Design antl Construc!ion � <br /> � Standa�ds and Specilications. <br /> 3.Cell Location Underground Service 48 hrs.bebm you dig.TOLL FREE NUMBER 1 800•424•SSGS. � <br /> 1 4. Tnsr.�l l r��r.•L cr,nstrur_ti�n ent.r��rn-�: 1-��h. + -��� r i�. -a;av .���. i � � . .,. � <br /> '"`� standard !l2UN and erosi�n c� ni.rnl. .. -. � � � , : �i I v I nLl ir �r i l�:-: <br /> ��� Insper,tor. <br /> . �i. Keep citY gtr�Pt;�; cl.Pan at all tim,. � <br /> 6. Curh �utter and sidewaik i_n the p? „t . i. ,: „n�i �m , ,,,1 . � <br /> any damage therato sh�ll be rPP];.�r��i ���. '� Ir: �ii :���r��i,ir��� , �t i "'� � <br /> +�� Puhlir. Wnrkr� Tneoectnr. <br /> 7 . AnY r_hanpe in the driveway r:nt, must be :;."vrnved hy t.hP Vul� I i �� � <br /> Works 7nspentor. <br /> '�� R. Acl.iust water boxes to gradP at Pn.i of ronr�trtictien. � <br /> �a,�� :?. llrivew�ys nhal.l. Ue completelv r,ured hefore ririvi»� on Th� io. <br /> 1 �'�i , � ACNIJOWLEDGEMENTOFCONDiTIqNS <br /> r.A� The under�igned owneVnpplicant hereby agrees to hold and savc hmm� <br /> less Iho Clly ol Everett fmm any antl all claims lor d..ni.iycs, costs <br /> � q nxpenses, or causes of action t�at may a�ise because o� n�„ioll,i6on <br /> � ��� � (] IJ�fI c b�� � /�, and maintenance ol ihe improvemeN or other�iqhi-ol-way usc hcre:o <br /> � �(1 i a,l r b �' � � � " apPlied for a�tl luriher agreos to remove same uRon ��,t,ro hom Iho <br /> � Approvetl lor ConstruG�ien Date � I Cily and lo replace public property damaged there�oq <br /> �� ' <br /> / _F���--_�-- S'- f- )' t <br /> f,'IAL INSPECTION Date — �--p.���-— <br /> Approved as Consirucled Signature ol Applmant <br /> � WORK AUTHORIZBD OY THIS PF.RMIT MUST BE STARTED WITHIN <br /> PUBLICWORKSDEPARTMENT 180 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS 10 <br /> � 3POOCedarStreet pE DILIGENTLY PURSUED TO COIdPLETION.THIS PERMIT MAV BE <br /> ^', `� R�ereU,WA 98201 CANC[LLED BV THE CITV UPON ANV STOPPAUE OF WORK ON THIS <br /> Pnm��c'258�6010 pI;OJCCT OVI.:R VO D�1Y5 DUfIiQInN <br />