Laserfiche WebLink
x- zo�-2� -s � , <br />� Date <br /> 4_2_y2 Punlir Worke>ermil• � � `i � <br /> eieq.oaP�.r �6 �Q +h-r + 46214 __ <br /> Application For <br /> PU[3LIC WORKS PERMIT PubTo�FeeFee s <br /> Less Appl.Fee Paitl S�Q- <br /> Print or Type Only TO POSTING ��5- �i `� B"e"`ao�e a �C90G, � <br /> p�::nell, WA 98011 485-9029 <br /> Owner Mai4ing Addre s City Zip Phone <br /> Owner <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work Construct ., w a�rtment omolex 3y�]1$QS., 1 Rec Bldg a F Garaaes) _ <br /> , ►42s W <br /> ?roject Address(it known) . �Q*h n SE � . H <br /> Atl:.ch four(4) copies of plans for proposed work• Draw to scale and note the following as applicable: � ' � � <br /> . • Property Lines • Centerline of street � <br /> • Outline and dimensions of all existlng and • Indicate North ��� - � <br /> proposed structures on the�ot • Show any proposed grading changes <br /> � • Existing and proposed utllities • Show me2surements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> i.All calls for inspection shall be made 24 hrs.in ad�ance-phone 259•8$10. � <br /> 2.A�I work shell be performed in accordance with this permit and cunent City of Everett Design and Construction <br /> ' Standards end Speciticetions. <br /> � 3.Cell Location Underground Sorvice 48 hrs.befare yuu dig.TOLL FREE NUMBER 1-800-4245555. � <br /> ��1. ��v� a�prv�,�_/ �,�i�s� �� /d-/� •9 Z O <br /> .. �: �v �a/� oul�side � �iad�dc�/ cT/�ac.� 4n � <br /> �/� -� C. ��' r / ,��^�i;.•�P�'it� /��ryiI �r/ �✓r c� � . ♦/� <br /> Q , � n� / i.T /993. '0 <br /> �/�2/z'a-e— `�, /�S OC , (Jl7�� /D rr / <br /> a <br /> ACKNON.'LEDGEMENT OF CONDITIONS <br /> The undersigned owner,applicant I�ereby agrees to hold and save harm- <br /> less the City of Even�tt irom anY and all claims for damages, costs, <br /> � expenses, or causes of action that may arise because of installation <br /> � � .� and maintenance of U�e improvement or-olher ri8ht-of-way use hereto <br /> applied for and furlhFr agrees lo remove same upon notice from the <br /> qp e C str i a�e Cit'y and to replace public propert damaged thereby. <br /> / <br /> � G' � v Q3 <br /> Flt�tf.'_ SPECTI N a1e — Dat <br /> Apprcved as Consiructed i re of Applicant <br /> VJGRF: AUTHORIZFfJ BY THIS PERMIT MUST BE STARTED WITHIN <br /> �A�I� PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Ceder Street BE DI�IGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everett,WA98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259•8810 pROJECT OVER 90 DAYS DURATION. <br />