Laserfiche WebLink
i <br /> � <br /> i <br /> i <br /> ,. � � �� <br /> � ,_ � -�_A-y� ,,i� <br /> n ��Date��� Pupi c Wods Przrmil s ,�9_< '/ <br /> Applicalion For �1°� ob�'.•-���'��y --- I <br /> QU6LIC WORKS PERMIT v�e�-W�.�,sF�o <br /> r��a�F« s _ i <br /> �essAnnlFeePa�� $ _ <br /> Print or Type Only 8��,���o�� s�C U� _ , <br /> � �'c h�� �br� �a2 4Q G uk. rr v�it�v L�..�r+ .inoC 9�7�� Z� 3 — 3 CSdL <br /> pwr�� Mailing Atldress Gty ZiG Phone i <br /> ScM -- _ I <br /> qpplicant Mailiny Address City Zip Phone <br /> DescribeProposedWork _ ivA(^f .Qirl/1�P i-bM��J fPS% A�t['P - �tlf �� APK�� �i� l)v/lSv��V.s <br /> J <br /> Project Address(if known) �-��� .7' �-'�-� �—��� ��`� lC/� � <br /> � <br /> Attach tour(4) copies ol U�ans lor proGosed work- Draw to scale and note the tollowing as applicable: � <br /> • Property Lines • Centerline cf street � �. <br /> • Our?ine and dimensions of all existing and • Indicate Norih <br /> Fr..�posed structures on ihe lof • Show any proposed grading changes <br /> 11 Existing and proposetl utilities • Show measurements � <br /> DO NOT WRITE bELOW THIS LINE � i <br /> PERMITCONDITIONS O �II <br /> t.All calls for inspection shall be made 24 hrs.in advance•phone 259•8810. � I <br /> 2.All work shall bu performed in accordanre with this p�-.r:*iit and current Ciry of Everett Design and Consiruction <br /> Standards and Specifications. <br /> � 3.Call Location Underground Service 48 hrs.before��ou dig.TOLL FREE NUMBER 1•$00-424-5555. � ��, <br /> y /> iS GfNADciiS9BG.� F,� As'��:ra�T To /�vsi.S'« � <br /> EXTE�tJ('!✓� AI�OG�A//.f (JF �+�NnSCf�,O//�/(r .ALpNU TNE <br /> bv'F_sr S�nf �� T�_< <',�'o�cs�n D�3�%���� vu� Tc- 'H� �. <br /> f�Cl TN9T /T /'�1Ay N.FfO ;O b'F .('�MOt/�i� /Ji/e'//✓G- � <br /> GXTENSiGN Q� T/-/� GVA7Ei2 � Sf�VPK MA/NS, /�� O . <br /> y,vL> p,i�i/, �'Aucr /N57AccATivn! i�v iHF ,y�'E� <br /> I.t//rf/��/ QNE 4�fAF'. ��Jc� Arrp, r .yr:�) � <br /> %+CKP:;'•,._EDGEMENT OF CONpITIONS ' <br /> The unde�signed oN��er.�a^plicanl hereby agrees to hold and save narm- <br /> � less the C�ly of Ew��retr vom any and all claims for tlamages, costs, <br /> expenses, or causes of action that may arise because of installation <br /> � // �� � , and maintenance or the �mproveinent or other right-of-way use hereto � <br /> ��"- �''���� . �� ��� applied for and further agrees to remove same upon notice trom the <br /> Approved for Con,truction ate City and to replace public property damaged thereby. ', <br /> ��/' , r s� � ���� c ��� �� <br /> FINAL INSPECTION Date �-��— `e-� �� � � <br /> Approved es Consiruded Slgnature of Applicant Date � <br /> everett PUBLIC WORKS DEPARTMENi WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED !41THIN <br /> � 3200CedarSireet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEH IS TU <br /> Eveietf,WA98207 BE DI�IGENTLY PURSUED TO COMPLETION. THI� PERMIT MAY BE ( <br /> Phone:259•6810 CANCELLED BY THE CITY UPON A'JY STOPPAGE OF WORK ON THIS <br /> PROJECi OVER 90 DAYS DURATION. <br /> , � <br /> I <br /> i <br /> I <br /> i <br /> I <br />