Laserfiche WebLink
.�.---- _� __ ..._._ _.. _. ._ .__ .. . .__ .:� <br />�� ������� <br />SEP �� B 1997 SEP n a,.";. <br />Date�'_'� � ��°.laT�1�1G -_. "'. ' <br />qpplicalion For <br />pIJBLIC WO�RKS <br />Print or Type Only <br />�I �� <br />— M <br />Owner <br />=_ /�. � <br />�i �� � �N <br />qpplicant <br />Describe Proposed Work � � <br />PERNIIT`�� <br />cG <br />J <br />n <br />Y' <br />I1. <br />v� <br />I� r•i <br />p (3r�X �DO `�' � <br />ailing Address Cily <br />�r^✓��,y � 5�,�� <br />� l Q 7` /.•}�� CN l: <br />m � � <br />CT et �'�' <br />i Cd <br />� .:ii ��: <br />P�b��i� Wo,k, F��m�� . Q S,il1 02 <br />Bidg. Oeot + <br />Poblm Ylorks Fea S, -� <br />Tolal Fce <br />Less Aaol. Fee V'a�a 5 1^� <br />.�� <br />9ala�ce Due <br />z�n <br />�JA 9go <br />Proiect Ad�ress (if knowr„ " " . _—'—'-- <br />Attach tour (4) copies of plans for proposed work - Draw lo scale and nute � CQo1iP line ol aPee1 able: <br />• Property Lines s Indicate North <br />• Outline and dimensions of all existing and Y Show any proposed grading changes <br />proposed structures on Ihe lol o Show measurements <br />f Existin9 and proposed utilities _ _ave <br />_ irc aFl nW THIS LINE <br />rnone <br />3�0,3�80 0 <br />- <br />Phone <br />PERPAIT CONDITIONS hone 259-8810. <br />1. All coils for inspection shall be made 24 hrs. in advance - p <br />2. All wori: shall be Performed in accordance with lhis permit and correnl City of Everetl Design and ConstrucLon <br />Standardc and Specifications. <br />3. Call Location Underground Service 48 hre. betore you dig.70LL FREE NUMBE.R 1-800•424-555 . <br />�, � �,, �Pp,-��Z� �r��, s d��-� <br />FINAL W—� SPE�T��N V <br />qpproved as Cons[ructed <br />pUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everetl. V:A 98201 <br />Phone:259�8810 <br />�/��,� t 1 <br />W <br />� <br />� <br />� <br />ACKNOWLEDGEMENT OF COPIDITIONS <br />The undersigned owner/apPllcaan h a d al�ccea',�s�fo�l dartl ges, costs, <br />less lhe City of Everelt Y <br />expenses, or causes acti n that may arise bacause ef ins�allalion <br />and maintena a;°� zryagr es to rern�ve ts me up1on noBcef iromrlhe <br />applied <br />City ai , lo r PI e public :rOperty d2ma9ed tl��reby. <br />-�- �'9 "y�,e <br />ature PP� t <br />WORK AUT ED F'! THIS PERMIT MUST BE STAFTcD WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />B�N�G��� pTgY P�E CUTYDU ONOANY STOPPAGEIOF WORK ON THIS <br />PFOJECT OVER GO DAYS DURATION <br />.. . , . „ .. : .� . <br />. . . .. .. �. � y ...� . . <br />— �• ,. ,..� :. , � .. . .. ;�.:,�. , � . .,. . .�:.. �.l <br />