Laserfiche WebLink
Date <br /> Publ¢Werhn Permit• <br /> ) � <br /> Application For eieo oeo� • <br /> PUBUC VJORKS PERMIT P��,01Fe;`°° s — <br /> I Leae 100� Fee PaiE S <br /> Print or Type Only e.�,��a o�e a <br /> l3�1 I .Q��.�'1 l � � I'��.1 ;/Y���' ci ��C� V-i1F�l_.�.� �-3�-�-`�13 <br /> Meil�ngAddresS City Z�p Phone <br /> (���5 (�l'Yl�$�;�� A , �-II�Y`Yl!����1� -7��.�P�,� <br /> Applictmt AteilmgAdtlress City 2�p Phone <br /> Doecriba Proposed 1'�ork <br /> Prolect Address�il known) � <br /> Attach four(4) coples ol plans lor pioposed work•Draw to scale and note the lollowing as appliceble: � <br /> • Property Linas � <br /> • Canlerlina of straet � <br /> • Ou�line and dimensions ol all eMisting end • Indicale Nor�h <br /> proposed 6lructures on Ihe lot • Show eny proposed prading chenges <br /> • Existing and proposad �itilifies • Show measuremenls <br /> DO NOT WRITE 6ELOW THIS LINE � <br /> PERMIT CONDITIONS � <br /> t. All cells foi Inepaction ehell be made 24 his. in advence• phone 259•8815. <br /> 2 All work ehell be perlormed In eccordenca with thia parmif and current City of Everetl Design end Construclion � <br /> Stande�de end Spedficatlona. <br /> 3. Cell Locetion UnAerg�ound Service 48 h�s, balo�e you dig. TOLL FREE NUMBER 1-BJJ•424-5555. <br /> �i�'�/C Cc/U/.',E S" f7r��/�JiT �!/D.— ,�'�'qvi,efG� � <br /> 8-�s�� (� <br /> ��� H <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDI710NS <br /> The undersigned owneriapplicent hereby ag�aes to hold and save hTrm- <br /> less ihe Cily of Everelt Irom eny end nll clalms lor demeges, cosis. <br /> expenses, or causes of eclion thaf iney arise b��ause ol instellation <br /> and meintennnce of the improvemen� or other righhobwey usa hereto <br /> App�oved for Canshuctlon applied for end further egrees fo �emove seme upon nolice �rom the <br /> Dete City and to replace public property demeged theraby. <br /> FINAL INSPECTION Date <br /> Approved as Construcled Slgnalure of Applicenl Date <br /> everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BV THIS PEqM1T MUST BE STAFTED WITHIN <br /> � 3200 Cedar Slreet 180 DAVS OF DATE PERMI7 IS ISSUED AND THEREAFTER IS TO <br /> Evxrett,WA 98201 BE DIUGENTL`.' PURSUED TO COMPLETION THIS PERMIT MAY 8E <br /> Phone: 259�8815 CANCEIIED BY'i HE CITY UPON ANV STOPPk.GE OF WORK ON THIS <br /> PHOJECi OVER 90 DAYS DURATION <br />