Laserfiche WebLink
� � � <br /> � „_ ., <br /> H 91='(�/91 �� 91/27795 <br /> '�� Dale ----� <br /> C � H r �i o�.�i . <br /> '"� y Applicati0n For <br /> � I+��;r��L WOIk!GCO <br /> PUBLIC WOHKS PERMIT r�,r,F« S <br /> N <br /> N <br /> K n <br /> �9 SO V.vPootim�nlo S _. <br /> �V � �V H.��ancr0ue S _ <br /> � � � Print or Type Only <br /> o � <br /> H � ° _ — <br /> � <br /> .�i � G�rv Stormu 2525 Viewctest !iv_e ���Y Zip Pnone <br /> Zy H � pµi��� biadingAddress <br /> t� y <br /> ry H —-- <br /> N <br /> " City Zip Phonc <br /> o N Mailing Atldress <br /> c� � r nnni�c:,�i <br /> H O tyi. <br /> Describe Pmposed Work �ddi Nn�y�-T8nev3b <br /> W <br /> 2525 Viewcrest Ave � <br /> proicci Address(it knownl �� <br /> ;�itach four 14)copies o�P�ans for proposed wo�k� Draw to scale ai�d note�Cc^�1ewine ol stPeel ��le-. /^ <br /> • P�operly Lines • Indicale North V� <br /> • Outline and dimensio�s ol all ezistin9:���d O Show any proposetl yrading chan9es <br /> proposed structures on Ihe lot � Show mr,asurements M <br /> • Eaisting and proposed utilities �y� <br /> � � DO NOT WRITE BELOW THIS LINE O <br /> i _ <br /> I ' �' <br /> �� P'cRMIT CONDITIONS ^ <br /> 1.All calls tor inspeC.ion shall be made 24 hrs.in advance-Phene 2 <br /> 59•8810 <br /> ! 2.All work shall be pedormed in accordance with Ihis permit an�cunent City of EveroV Des�S���nd Construction � <br /> � �_ Standards and Specifications. � <br /> � ' 3.Call Loca:ion Undergmund Service 48 hrs.belore you dig.TOLL FREE NUMBEFi 1•800•424•5 . <br /> � T ' O <br /> /��L ::r c._��-/`' , . .. . - . , }`. <br /> .; ar.� �'i � <br /> �/ <br /> '` o <br /> w,� <br /> � <br /> ��1� . <br /> � ACKNOWLGDGEMENT OF CONf]ITIONS <br /> �! `w 7he undersi ned owneNapplir,ant heieby aorecs lo hold and save harnr <br /> �Iw less the City of Everetl irom any and all claims for domages, costs. <br /> ¢xpenses, or causes ol action Ihal may arise because o� installatior. <br /> � and maintenance o� Ihe improvement or other nghPo4w��y cse hnieto <br /> apPlled lor and Wr�her ag�ee5 to remove 's�ine upcn i>>hce Irom Ih�� <br /> Appmved lor Gons�ruction <br /> Date Ci�y and Io replacC publlc p�oper�y dama9e�1 �herrby. <br /> RNAL INSPECTION Date — D�te <br /> Sipnalure of Applicant <br /> �pprovedasConsVucted VdORK AUTHORIZED BY TNIS PERMIT IdUST �[ STARTED WIIHIN <br /> /��}� PUBLICW�RKS�EPNRTMENT 180 DAYS OF DAT[ PERMIT IS ISSUED AND THEREAFTER IS TO <br /> �' 3200CeAarStreel BE DILIGLNRY PURSUED TO COMPLETION.THIS PERMIT MAY E3[ <br /> � �M� E�roml�,WA 99201 CANCHLI ED�Y 11�C CITY UPON AIJY STOPP�G[OF WORK ON THIS <br /> Phone�.2S&BH10 PHOJECI OVE17`-�q (�,�fS UUt7MION. <br />