Laserfiche WebLink
� _ ._ <br /> 10/15/93 � � �Z� " S C�3�4ej� �_ <br /> Date Pu�lie Worka Permll+ <br /> Tn pn�r�n�r _ � -�s�� BlagOeotr <br /> �7_�79--- <br /> Application For <br /> PUBLIC VIIORKS PERMIT P°°��°v'°�k°`aa — <br /> Toial Fee $--- <br /> Less Ao01.Fee Paia $ ,n _ <br /> Balence Oue $ �(/ <br /> Print or Type Only <br /> Lyle Blank PO Box 2266 Everett WA 98203 355-4725 <br /> Owner Mailing Address City Zip Phone <br /> Same <br /> Applicant Mailing Address City Zip Phone <br /> New house <br /> Describe Prop�sed Work <br /> �/� ,_,y�� �y,� I_ W <br /> ProjectAddress(if known) "��J� � � �`^i �I�ICGL LOt 2 S.P. 1113/93 � <br /> At;acn four(4) copies ot plans for proposed work- Draw to scale and nole the folluwing as applicable: � <br /> • Property Lines • Centerline of street � <br /> • Outline and dimensions uf all existing and • Indicate Nor!h <br /> proposed structures on the lot • Show any proposed arading chanyes <br /> • Existing and proposed utilities • Show measuremen!s � <br /> DO NOT WRITE BELOW THIS LINE o <br /> FERMIT CONDITIONS . <br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone 259•8810. � � <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and Consiruction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL F�iEE NUMBER 1 800�424•5555. � <br /> i <br /> I � . <br /> � <br /> �/ <br /> � <br /> a <br /> ( ACKNO�VLE�GEMENT OF CONDITICNS <br /> �o/� <br /> SN"v The undersigned owner/applicanl hereby agrees to hold and save harrtr <br /> " �I less the Ciry of Everett (rom any anA all claims for damages, costs, <br /> /�1 ezpenses, or causes of aclion that may arise because of installation <br /> l ,L���� [�/�G�.,n ��,1- ZS [. , i ano maintenance of ihe improvement or other righhol-way use hereto <br /> '/� //� �X— vv I-'' aPpiied lor and further agraes to remove same upon notice from the <br /> Appro�ed for fonstr ction � Date � Gity an lo replace public property damaged lhereby. <br /> ��l/-�_� s-�- sy /�S ,� <br /> FINA� INSPECTION Date <br /> Approved as Constructed gnature o Applicant Date <br /> PUBLIG WORKS UEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETIUN. THIS PERMIT MAY BE <br /> Everetl,WA 98201 C^.NCELLED BY THE CITY UPON ANY STOPPAGE OF 11'OiiK ON THIS , <br /> Phone:259�8810 PROJECT OVEFi 90 DAYS DURATION. <br /> I <br />� -- -- --— ' ' <br />