Laserfiche WebLink
Date 1� � <br />qpplication For <br />' PUBLIC VUORKS PERI'VIIT <br />��(.�� J �� <br />Print or Type Only �- <br />Bieo�J ot�� Pn'/ �/ / ^' �// �. �/ __ _ <br />PaOiicWorMSFet '],,,J, C b <br />Tot�l Fee a �' ---�'— <br />Leve Appl. Fee Vevl S <br />•yo . o c, <br />Be�mcx Due 3 _ <br />�� <br />Bovden Real[y Inc 1429 Broadway _ L'verett _ 98201 25.�.-1166 <br />Owner <br />Melhn,r, Fddress Clly Zip Phono <br />Boyden Realty, Inc., dbn J 6 D tiuilders, 1429 Brondway,Gverett, 98201 252-1166 <br />qppllcen� Melling ��AA�P54 (ti�y Lp Phone <br />New ain le familv residence ___ __. <br />Deacribe Propoaed Work —g-- — <br />Prolecl Addreas (II known� ?18 — 9E th Pl S E — Pre. <br />Attech foui (A) coples of plens lor proposed work � Drew to scale a�id nole ihe lollowing as epplicable: <br />O Property Llnes <br />• Outllne and dimenaions al ell e: Istii�g and <br />p�oposed siructurea on Ihe lot <br />• EHisling end proposod u�llltifls <br />• Cenlerlinn of sireet <br />• Indicete North <br />• Show any proposed grnding changes <br />• Show mnesurements <br />PERMIT CONDITIUNS <br />L All cells lor i�spection shnll be mnde 24 hrs. in ndvance � phone'259•88i $. <br />2. All work shell be perlormed in eccordence with this permi� and current City ol Everelt Design and Consduclbr <br />:,�enda�da end Specilicelions. <br />3. Cnll �ocetion Undarpround Service 4B hrs befoia you dic�.'I'OLL FREE NUMBER 7-800•424•5555. <br />— / <br />� ;' I <br />�Jd_ / ( / !c {ls�-�.— .. /. •'- 1 d- 3 <br />Ap�roved lor Conslructicn Dete <br />. ��z�� _ <br />FINAL INSP 710N Dnte <br />Appwved es ConslruCtetl <br />��P�P�� PUOUC WORKS DEPARTMENT <br />� 3200 Ceder S�reel I <br />�verelL WA 9B?O1 <br />Phonc 259�8015 I <br />ACKNOWLEDG[MENT OF CONDITIONS <br />W <br />H <br />� <br />N <br />The unAersigneA ownedapplicant hereby agroes to Iwld and sava herm- <br />iess the City ol Evarett I�om any end all clelms lor demages, i �sls, <br />e.penses. o� cnuses of ection that mey arise beceuse of instellalion <br />end maintonance of Ihe imp�o��emont or o�her Hght�ot�wey use hnreto <br />epplied for anA lurther egreea to remove enme upon notice from th� <br />Clly and to replece puhlic property dameged therehy, <br />� � -, � , � <br />�< �; , - <br />�__.�-.� . ., ' .' - Dale <br />Sign.�ture of Ap�licent <br />WOFiK AUTHORIZED BY THIS PF:RMIT MUST BE STARTEO WITHIN <br />1B0 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTFP IS TO <br />EF f11LIGENlLY f URSUED TO COIdPLETI(�N. THIS PERMIT MAY [i[ <br />GAfJCFLLED Bv TIIE CITY UPf�H ANY STOF PAGE OF WOR1l OM llilS <br />PFNJECT OVEa 90 DAYS DU' ��fION <br />