Laserfiche WebLink
�ate ) 3o J Pub�¢Wor�aPnrmi�r° S ��� <br /> Appllrq�lOn For e�ay Deo� • _._ <br /> PUBLIC WORKS PERMIT P�D4<Wo���fee — <br /> foiuiee S <br /> lean eooi Fee�ua B <br /> Beience0ue s ��— <br /> Print or Type Only _ — <br /> SN�NM !..�'v1/S �„t t��p. 23/2 /3����Sh/- t�HN� 9��.�� 7�j'-r�.�l'l" <br /> Owner Mailing Addreas �Ity' Lp Phono <br /> s�iG � /�,-c <br /> Applicant Mailing Address Cqy Zip Phune <br /> Descrif�e Propos=d Work /"' /^ `'/�`�� ��•�Y �3�i(.w« ��f��C✓ _ <br /> — `n / .�y C��L�f�ci PP� l)���1 � -- <br /> �� <br /> - 5�i2 /�y �` --- W <br /> Pro�ect Address�il known) . ..i 7� ...r E � <br /> AUwch fnur(ry copias ol planv lor oroposed work� Draw lo scale and note Ihe lollowing ns applicable �� <br /> • P�operty llnes • Cen�urline ol sireel � <br /> • Outline and dimr�nsions of ell exi��i�g and • Indicale No�ih <br />. proposed Slructure5 on�he lot • Show any proposed grad�np cF^�.gas <br /> • Eaisting end proposed u:iiilies • Shcw measuroments � <br /> w <br /> UO NO7 WRITE BrLOW THIS UNE O <br /> PERMIT CONUITIONS <br />. L All calls lor Inspection shell b..� matle 24 hrs. in advance- pt�ne Z59•8B�S. � <br /> 2. All work shell be Verlormod in accordance with U�is permd and�urrent Cily ol Everett Design and Construclwn <br /> SlanOerds and Specifications. <br /> 3. Call Lotatlon Underg:ound Service 48 nrs. belore you dig. TOLL FREE NUMBER 1-800•424�5555. � <br /> f�r �Q ,tkiT ���isf! O.t'[.�WiCS �S�sri�n.+s. ��7"�,5r�, c-_� � Dl�e C ��.-vT:% �/' <br /> �JDJ9tEn/7 COTJ, <br /> -S G�qOE LU77 Sc�i f�J' it/OT Ti Irn,�ql,– �Cd�c'.!'-�,i,�/n .��,_ � <br /> Lors LUiY/ .C�A��✓N�VTEt .f'UN�1JfY, � <br /> �. Cf.�v�/Fcr ���,tivt/.,;-�dvrr rc v,.'9,.✓A;,t� iry,f;c n9. O <br /> � .'9itJ� S�� Gd,Cf3 � �i(AJlE•_ e7�e?OtEn/ DU.�'irt•�G T//J Cr�n/,(!i'Ur '. "�-� � <br /> /�.��ST [?E �FEPc f![E��• <br /> B. 1� D�u.l Cj/.o�/�,C-'.f 9.eE NEtErr�:�� , /'E�r.,✓ei P,✓t� <br /> I�ss'�iTB•J A�ce �c�v.�E�', <br /> ACKNOWLEDGEMENT Of CONDITIONS <br /> The undersigned owneqepplicenl hereby agreec to hold nnA save haim� <br /> less the Cily ol Everetl Irom any nnd all claims lor damapea cosls. <br /> / / expenses. or causes of nction Ihat mny anse because o� mstai�n:ion <br /> ��j �,�/�,L�/v ���/9` and mamtenonce ol the improvement or other rlghPol�.vay use ha�elo <br /> ���� E'� �' Bpphed lor and lurther agrees �O remOVC 9Artlf UpOn nohce Irom Ihe <br /> Approved lo Construclion � Dnte <br /> /� Ctl�y7-ann to replace pub6c property damaged Ihereby <br /> r F/� , ` � ✓I�7� J-ry.l.��tn, SSd N �1y-S�- '!'Y� <br /> fINAL INSPEC110N Date �� ' �'�42�—�� �i�t � <br /> Approved aa Conslructetl Siynature ul Applir.ant ��' Date <br /> pypll+ti PUBLIC WORKS DEPAFiMENT WORK AUTHOR12ED 6V THIS PERMIT MUST BE ST�RTED WITIiIN <br /> � S200CederSlreet 180 DAVS OF �ATE PERMIT IS ISSUED AND THEFiEAFTER IS TO <br /> Evrrelt, WA 98201 BE DILIGEN�LY PURSUED TO COMPLETION. THIS ?ERMIT MAV BF <br /> Phone�. 259�9A15 CANCFLLED BV THE CITY UPON ANY STOPPAGE OF WORK ON iNIS <br /> PFOJECT OVER 90 DAVS DURATION. <br />