Laserfiche WebLink
11'PE OR PRINT ONLY <br />.ppliC¢tpn For <br />PUBLIC ORKS PERMIT <br />PUBLIC WORKS DEPAHfMENT <br />3200 Cedar Streat <br />Everatt, WA 98201 259-8810 <br />Lisa 1.nfond 157.0 112th St SIJ Everet <br />Auzz thc Tower <br />ApPlicant <br />Describa Proposed Work <br />Stand <br />drive Chru ee <br />PROJECT ADDRESS (if known) _ <br />��- <br />h�te I-19-99 ____ <br />Wblic Works Pertnit M _��"`LZ <br />ppllding PermH N 61400 <br />u <br />Publl Nbrka Fae S _ �� <br />Q;:������ � 6� <br />�$�(i� '�5`�n+353�5789 <br />City J Zlp. Phone <br />i, 9��� <br />� s fU a.�. c.�7'i .�. �' ZIP <br />12th St SW <br />Atlech four (4) coplea ot plans la propoaed work - Orew to acale and nota the followlnp N epplicable: <br />`Property Lines 'Out6ne and dimenslons ol ell exlsling end proposed etructuree on the lot •Exlating end proposed utllNles <br />'CentMine ot etreel •Intllrate North `Show �ny propos�x� greding chengos •Show meaeurementa <br />PERMIT CONDITIONS: <br />1. All calls for Inspection shall be made 24 hours In a�vence - phone 259-8810. <br />2. All work shall be periormed In eccordance with this pertnit and current City of Everett Design and <br />Constructlon Standards and SpecHications. <br />3. Call Location Underground Service 48 hrs. betore you dig. TOLL FREE NUMBER 1-800-424-6666. <br />� / i�%�-^.. � % <br />Approv lor Constructlnn Da <br />FINAL INSPECTION Data <br />Approvod as Conatructed <br />W <br />H <br />- <br />� <br />� <br />� <br />O <br />a <br />ACKNOWLED(3EMENT OF CONOIT10N5 <br />The unEeralgned owner/applleent hareby egreee to hold end save hertnless <br />the Clty of Everett from any and alf claims lor damages, wsis, expenaes, or <br />eauses ol actbn ihel may ariae beceuse ol Installefbn entl maln�mance ol <br />Iha Improvement or other right-of-wey use hereto applled la end h�rther aproea <br />to remave anme upon notke fmm Ihe Ctty and to replece puWlc pioperty <br />tlamaged �he;qby. <br />/ � � <br />� l'�7 • /' ,'�!' - %'/ <br />S na 1Applkant - Date <br />WORK AUTHORIZED BV h115 PI:RMIT MUST 8E STAqTED WITNIN 1B0 OAYS OF DA1E PERMR IS ISSUED AND THEREAF7ER IS TO BE DILI6ENTLY PURSUED TO <br />COMPLETION. 1 HIS PERMIT M/�Y BE CANCELLED 8V THE CITY UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVER BO DAYS WRATION. <br />