Laserfiche WebLink
� � / <br /> �` - _ '" ".:'_ � v,.oi.��:o.�..r�.,,n . —/c-/l �•r . <br /> Dala_3'S'92 emo 000� •�5856— <br /> Appli.;almn For - <br /> PUBLI� N��►RK� f�R�#61� z �� - 3 P�e�,�wo,,,F�� S — <br /> � 9 ,o„�F�� <br /> tesaAON cee Pn�a 5 <br /> G C4� <br /> o.,i �o�� s --- <br /> Print or Type Only <br /> 5t�"�I <br /> �'� � y Rverett SdA 98201 258-4331 <br /> � � .� Beam Construction 3514 Uroadway pnonc <br /> C y y hlaJing Add�ess Cily ZiP <br /> p Owncr <br /> H � �. <br /> y H OWilei phonc <br /> Mailin9 Address City Z'G �.� <br /> � y� ,lpplicanl ( -^ <br /> �IH�J � ��V . . <br /> [n F+ new SFR Lot 1 S�AV <br /> x Describe Proposed Work <br /> � y d TQ pns;iNr, <br /> ��� _ W <br /> c�� o � <br /> z H`� Z4Z3 \���/��c-_5 i .+�`'e --—-- <br /> 9 H z Prolecl Atldress(il knawn� _ <br /> t� <br /> ~ y Attach low(•1)copies ol Plans lor pwposed work�Draw tn scale and note the followin9 as applicable� � <br /> � y • CeNerlme ol street <br /> �y • Property lines • Indicale Norih <br /> • Oulline and dimensions o�aIl eaisting anA � Show nny nroposed gradin9 chanycs <br /> �� r proposed slruclurCS on Ihe lol � Show mcasuremenls � <br /> Ci7 • Exisling anA proposcd u�ili�ies <br /> a�e� <br /> y � � DO NOT WRI7E BELON THIS LINE O <br /> �� PERMIT CONDITIONS �\ <br /> �� i.All calts br inspeclion shall be made 24 hrs.in advance-phone 259•8810. <br /> � 2.All work shall be Pedormed in accordanca with Ihis permit and wrrent City ot Everelt Design anu Gonct rurtion 1" <br /> i St2ndards and Specifications. � <br /> �, q J.Call Location Underground Service 48 hrs.before you dig TOLL FREE NUMBER 1 800•424 5555 <br /> �� 4 . 7nst.nil i�n�-}� rnn;rructi-on enYt mrr- n- hin�l liiv��w:�v �^ �xr �ir,v /� <br /> ,1t.:�n�3nrri N2��R �nul erosior� r�� nt.rnl -, - �1+ r�=� t �- �i i�v F�u7- �� i �� 4 rk:�� � <br /> Inspectnr. <br /> • �� - . Kr:eP city si:reets r.l.ean at zl ]- timaA L <br /> i ��� Cilrh gut.t:er and sidewalk in the plat are new and uncamae���. r- <br /> anv dama�e therPt.n ;h?11 hP reFlaced aY, the di�cretinn nF � hr' �/� <br /> Piiblir. Works Insp�ctnr. V� <br /> i , Am� chan�e i_n the driveway �vt, mugt, he approved bv th•' P��t! i �' O <br /> ����� Wnrks Tn�pecit�r. . <br /> , Ad.ivet watvr Ln>:n= t.�-, r*ra�ie �h t=n�l ��i cnnat.rnrtion. A <br /> ��� ��:ivew�v^ ;hall � �� rnnif�let-.�lv ,-nr�=�i h��Porr� ,irivi��t �,., t.hem. Vi� <br /> I.t' ,o. 3,,�u��n9�� v.��.-r�+p.r.sc�s S�-1r�u, N o7 �c.e��t-1 �r•�;z� �,�-wi� , � <br /> ll. LON�IELT �o.vNSt�JTS Ta DRJ�I� SYS�^'1• <br /> ACKNOWLEDGEMENT OF COND'TIONS <br /> I The unde,rsi9red owner/apPGcanl here6y a9rees to ho�d and save hann� <br /> 'i -' ��..ss Ihe City ol E�.erelt Irom a��y anJ all claims lor damages, cosis. <br /> I �_ ,^L� � enpenses, •'�ses ol action that may arise 6ecause ol installalion <br /> `� J � C �19�„ 3— I y— 9 Z ano maint��� �ol Ihe unprovement or other ri9h4of-way use heietu <br /> applied lo _ �riher agrees lo remove same upon notice fwm Ihc <br /> Approved tor C_onstr�uction Dale Ciry a�d�� � � ���Public property damaged Ihereby. <br /> �\/„ ,/. _�_ _ ]-�x' � �� ��q eS. J✓" S' ��' /Z� _ <br /> ✓. ,._ I - <br /> FlNAL INSPECTION Da'e — Datc <br /> Sign3lurC��A� iic'a . <br /> qqproved as Constructetl y�pRK AUTH ILLC P � THIS PERMIT MUST OE STARTED VJITHIN <br /> � PUBLICWORKSDEPARTMENT 180 DAVS ]F iJATE °'�RMIT IS ISSUEU AND THEREAFIER IS TO <br /> 3200 Cedar Street BE OILIGEt.TI . ^'JAS�EO TO COMPL[TION THIS PER611T MAY B[ <br /> Lvmc�Ll4'F 9�201 C�NCGLL' ' E�Y�Ni CITY UPON�NY STOPPAGE OF WORK ON THI9 <br /> Phone'.25n�tlB10 �'f70J!'C1 U' EF'lt �AYS DUR�TION. <br />