Laserfiche WebLink
L�] LT1 � <br />A�x <br />C H <br />9Hcn <br />H > <br />H z� <br />�! f] <br />H �f <br />O 5C O <br />'� Fi'� <br />(q H <br />� r <br />��d <br />OH <br />H�g <br />�. �g <br />a y f� <br />[� �i <br />Ny <br />8 H <br />c� C7 �n <br />� � Cs1 <br />H O tyi� <br />f... ..� <br />_� <br />�— .�. <br />_., ! <br />(�� <br />� � <br />� �..� <br />,� _ <br />�� <br />, <br />/�" 4 _ [/� <br />Date <br />Application Por <br />PUBLIC WORKS PERh9�T <br />Prinl or Type Only <br />y` _'�'3_ ' <br />i <br />Pum�cvrnilava�mn. - <br />oiao aeoi . — — _ . _ . <br />auei�cwa�biee S <br />TOlnl Fee <br />Lrt�AOttl (CeGn�� S <br />na�.����,.o���• 5 ��% <br />Describe Proposed Work <br />i22d � %�/i <br />Project AdAress (il known) <br />i <br />Attath lour (4) copie5 0� Plans lor pmposed work - Draw W sc�lr. :,nd note ihe lollowing as applicahle: <br />• Property Lines • Centerline ol street <br />• Outline a�d dimensions ol ,.II exls�ing and • Intlicate Norlh <br />proposetl Slructure5 on the lot • Show any proposed yradin9 changes <br />• Ezisting and proposed utilities • Show measurements <br />PERMIT CONDITIONS <br />1. All calls lor inspec�ion shall be made 24 hr5. in edvan �e - phone 259•SBi 0. <br />2. All work shall be pedormed in accoidance wilh this permit and current City of Everell Design and Construction <br />Standards and Specilications. <br />3. Call Localion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424-5555. <br />�{ .� p �� L� �� rz s��ic�-e ��� -Ft� � r-c s�-�. k�„- LA <br />(.� n d ;�\w-C <br />J <br />C <br />l �.� o a' <br />APPwv lor Cons 1(yf � , ate <br />_i \' �6.1�-�-+---- //= � ` <br />FINAL INSPECTION Date <br />Approved as Ccnstructed <br />�P'JBLIC WORKS DEPARTMENT <br />� 3200 Cedar Sireel <br />Everelt, WA 98201 <br />Phone: ^5&8810 <br />ACKNON'LEJGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />Z <br />� <br />,�^ <br />V♦ <br />A <br />a <br />The undersigned owneVa.pplicant hereby a9rees to hold antl save harm� <br />less the City ot Everetl Irom any and all claims for damages, costs. <br />Czp@nSeS. or caUseS ol aCtiOn Ihdt may erise beCause ot m5ia�l2�ion <br />antl mainlenance ol Ihe improvement or other right-ol�way use hereto <br />applied for and Wrther agrees lo remove same upon notice Irom the <br />Ciry and lo repl�ce p��Ulic proPerty damaged ihereby. <br />i ��//� <br />Si�nature of Applicanl Datc <br />WORK AUTHORI2E BY THIS PERh11T MUST BE STARTED WITh{iN <br />180 DAYS OF DATE PERMIT IS �SSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSU[D TO COMPLETION. THIS PERMIT MAY BE <br />C�NCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />