Laserfiche WebLink
nc. . <br /> � ' II <br /> � � ' I Pueer.vrnm vn,mn. .. <br /> Date�l�cf� o��, o�o� • �f�.��23.id`�— <br /> qpplicaYon For _ <br /> PUBLI� WORKS P�RMIT Pub�KY/O�ffeC 3 <br /> TOINI FII< <br /> Usf A[OI fC Prid S <br /> Bdldn�.fDuf 5 <br /> z�� Printor '�y(:eO::ly — <br /> [�:l+1 <br /> o�x /id/ 1i� /ds'�rd Jf <br /> � H � � ,�_ J�tt��s:_��_,3�e3-/��/ <br /> �-�i xy �f�tP�'� �OA� f/' Z�p � Phone <br /> �"� p� Owner tdawng AAdwss L Y <br /> !� 1:H <br /> ft � <br /> /a.� <br /> d 50 �� �nin _ ----Z�p Phone � <br /> � y H APPlicanl IJailing AAdrecs Crty �. <br /> � O� /N �I'i/)r �d�/'N/'(' /Y1 �JNF1lJ�d �� �'�. II, <br /> y Describe Propo�ed WorA <br /> � �g ._ - --- - - - <br /> c�• o � ,, <br /> � y� - -- <br /> � '�y Proiect f.tldress 1�1 knownl - ���`� �v�-^-���-`-�-�ri � Z -_ — � <br /> g � � <br /> H <br /> O Cy UJ Altach luur�4)copies ol Plans lor proPosed work-Draw to scale and note Ihe followmg as apP ica�c� � <br /> • Property Lines • Centerlme ol street <br /> � [�i� • Outline and tl�mrnsions of all existing antl • Indmate North <br /> � $how any Gropos9d 9radmy :hany�s <br /> y HO y proposed simctures on ihe lot � Sp,a�v measur^ments M <br /> • ExiS�ing and prCposed u�iliiie. W <br /> DO NOi WRITE BELOW THIS LM[ O � <br /> PERMIT CONDITIONS � <br /> 7.All calls lor inspeclion shall be made 24 hrs.in advance-phone 259•8810. <br /> i 2.All work shall be pedormed in accordznce with Ihis permit and current City ol Everett Design and Constmction <br /> Standards and Speciliwtions. � <br /> �... 3.Call Location Underground Service 48 hrs.helore you dig.TOLL FREE NUMBER 1•$00•424-5555. <br /> ' ' / O <br /> � <br /> � �. <br /> L L�K:' �Cc'����i��=oon< �/�7�' /.°�i'.',L< <br /> ��c- < <br /> �---� �;�'/�;�-�_ �" <br /> - - i� .�- �r <br /> �.... _ � <br /> -� � <br /> _ �, a <br /> �„ � ACKNOWLEDG[MENT OF CONDITIONS <br /> The unde�sinned owner/applicanl hereby ag�ees to hold and save harm- <br /> + _ _ less ihe CAy o� Everett Irom any and all claims tor Aamages, ccsls, <br /> expeises, or causes ol aclion lhat m�y anse bewuse of ins�allat�on <br /> ;�,� and mainlenance ol Ihe improvement ur olher ri9hPohway use hereto <br /> � ' ' .— applied �or and lurther agrees lo remove same upon notice ��om Ihe <br /> Approved tor Consiruction ��+�e ��iy�ntl W r�place pu6lic property damaged ihereby. <br /> FINAL INSPECTION Datc Date <br /> ApPwved as CensVucted Siynature ol Apphcant <br /> WORK AU7HORIZED BY THIS PERMIT MUST BE ST.ORTED WlTiti4 <br /> eveirtt PUB�IC WONHSDEPARTMEN7 I 180 GAVS OF DATE PERMIT I5 ISSUED AND THEREAFTEP IS 10 <br /> O 3200CedarS�ree1 I BE OILI(iENTLY PURSULD TO COMPLETION. THIS PERMIT h1AV 8E <br /> Everetl,WA9E201 CANC�LL[n BY THE CITV UPON ANV STOPPAGE OF WORK ON Ti�IS <br /> Phonc 259�9810 PfiOJCCT OVER DO D:1YS DURATION. <br />