Laserfiche WebLink
v" ' <br /> Date � �I PUGLc Nbrks Per �s �� —p��/�� <br />" Applica�ion For eiea�oeo��•� ��� � <br /> PUBLIC WARKS PERMIT P�OIicWornsFee ` <br /> total Fee S <br /> Less Appl.Fee Peltl $ , <br /> ealonce0ue S ��CC, I <br /> Print or Type Only <br /> `�-r� C � �' lDs l� - /���,-e.f� 3 � 7 -/.���� <br /> Owner Mailin�Address City ZiP Phone <br /> _�� �ir-�.� <br /> Applicant Mailing Address City ZiP Phone <br /> Describe Proposed Work �^ `� �' n'e'�`p� <br /> W <br /> --- �1��5� - ��hsf- F.. <br /> Pwject Address(if known) <br /> 4tlach four(d)copies of plans for proposed work- Draw to scale and note�he following as applicable: � <br /> i1 Property Lines N Centerline ot street � <br /> • Uulline and dimensions of all existing and • Indicate North <br /> proposed struclures on the lot S Show any proposed grading changes <br /> • Existing and proposed utilities p Show measurr.ments /� <br /> W <br /> DO NOT VJFITE 9ELON�THIS LINE O <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hrs.in advance- phone 259-881 5. � <br /> 2. All work shall be pertormed in accordance with ihis permit and current Ciry of Everetl Design and Construction <br /> Standards and Specificalions. <br /> � 3. Call Location Underg�ound Service 48 hrs. belore you dig.TCLL FREE NUMBER 1-800•424-5555. � <br /> '�, l'�P���G/?�vT /S .C'E['�ci.EC"U T) COn/ST,2vcT S.O�����« O <br /> f1�E//i.V.:J F�t'iS.—.r✓G G'[/�z�-� /°•v0 Gfillc—!_� f E�: G.Y <br /> �S'.,-a.✓:�a�n r� �_nG, � <br /> .? J,us,-a�e Dc.�•���<.qf;• .�FK s':-�,voa.ec� ,�;o� �' f%E�= � <br /> � G� c- ��•�n.FiT �._ �_ .ti � <br /> sEc;;�,� .�.3. , o,r ,;� y � ,« , <br /> •# Cc:iJJi�'uC7�i�� �rs%NOFG-C?C. � <br /> '�- `�� - f� <br /> �✓. ���s'c�LF,�/T VVr=% 4'c� ,t�E(JOiP_:.� . d f-' f ' i <br /> ' F�_ %i�r S�.'ir"cJflc%' �.� 1't !:,7��Sif'o'CT�L� <br /> rC.?Cn.'mA.JCt � � <br /> �.�;iO,�,p�rJ�" ACK�OWLF.DGFMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> — - less the Ciry of EvereV from any and all claims for damages. costs, <br /> ^ / '� expenses, ur causes of action ihat may arise because of installatiun <br /> c___�(������� cef� /��- and maiNenance ot the improvement or niher righFol•way use hereto <br /> /X.� , �Yl�, &,- / <br /> applied for and furlher agrees to remove same upon notice Iroin ihe <br /> Approved tor Constiuction / �� Date City and to reFlace public property damaged thereby. <br /> // ��% /-o?G - �'� 'L�-�---� S^ �1 <br /> Fl �SPECTION� ' Date � /� <br /> Approved as Construct_�9 Si aWre ol Applicant Date <br /> evrrett PUBLIC:WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MU BE SYARTED WITI IIN <br /> 1d0 DAYS OF DATE PERMIT IS ISSUED �ND THEREAFTER IS TO <br /> � 3200 �;edar Street BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Eve�ett.N'A 98207 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone: 259-8815 pqp�ECT OVER 90 DAYS DURATION. <br />