Laserfiche WebLink
' ` ' " „ ..�. �-c � .4�`„'`,t ., :f�.:y,...s � . �f+ �.k • ,« . . ,:l;z.- _, -r ,....�-- : � - i . . . <br /> ,�. <br /> DetE�� •. � •. � 1 a�oicwo,e.r ,mn. , . <br /> Application FOr eiao.Dea�.. <br /> PUBLIC WORKS PERMIT PueiotelF«`� . <br /> Lesa�ool Fee Pai� S <br /> Print orType Only esia��eo�� f � (� .? f <br /> o — L�c�-n �� c� .i tiC QU��((I�2 (r'�¢tt CI� - aS� �io'7 <br /> Own r Mailii.7 Atldress Gry Z�p � Phone <br /> �AM � <br /> Applicant MaJmg AAAress Cdy 2ip Phone � <br /> Describe Proposed Work � / <br /> O�-� — <br /> ,� � 4 � � 4 - � W <br /> ProlectAddre551i1 'anown) ��_ % � <br /> Attach bur(4)copies of plans for proposed work- Drew to scale antl note the followiny as applicable: � <br /> • Property L ines • Centerline of street � <br /> • Outline ane dimensions oi all existing and • Indicate North <br /> proposed siructures on the lot • Show any proposed gratling changes <br /> • Ezisti�g and proposed utilities • Show measuremenfs � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All r,alls for inspecti�n shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.All work shall be peAormed in accordance with this permit and current Ciry of Everett Design and Construction <br /> Standarda and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TO�L FpEE NUMBER 7•800-424•5565. � <br /> � � . <br /> � �:�.�� � `�'i"u�.R-�J.� /'-P_-�'".c.i`�a=� ,G-ti-��. 1��� r� O <br /> �. <br /> ,,� ���'Y1.ac-�-�t,�,t �p � ,�1�'"-�t�� G��.R-�,� ��.�,eua—i,_.��1�,�-.�,� � <br /> �,t� , , , , , / � <br /> lJ / � lJ-(.c/�' � O <br /> �.� ..�� ��zCtil� (,��-<-�C'--P� �}l'l_ �t.G7 ���' ii�� � � <br /> U �� <br /> ACKNOWLEDGEMENT Of CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> , less the City o erett irom any and all claims lor damages. cosis, <br /> /� ^ expenses. or au es ol action that may arise because of inslallation <br /> � (��'r�� S� X � �J} anA mainte oi e improvement or other righFof-way use hereto <br /> V V applied I a �ur e:. agrees to remove same upen notic irom the <br /> A proved lor C n t�uction � Date Gry an e ace puqhc pro erty damaged thereby. <br /> / I �� <br /> FINAI INSPECTION Dale <br /> Aporoved as Constructed �ign W e ol ApplicaM ate <br /> evrrMt PUBLIC WORKS DEPAHTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE S ARiED WITHIP' <br /> � 3200CedarStreet 1A0 DAYS OF DATE PERMIT IS ISSUED AtJD THEREAFTER IS TO <br /> Everett,WA 98201 BE DII.IGENTLY PURSUED TO COMPLETION. THIS PEFMIT MAV BE <br /> Phone:259-8870 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TtiIS <br /> PROJECT OVER 90 DAVS DURATION. <br /> i __ —_ ___.___— — <br />