Laserfiche WebLink
Date 3/17/9:, <br />Apolic;�(�on For <br />PUBLIC WO�RKS <br />Print or Type Only <br />Oakcrast NOmea <br />Owner <br />$COCt %i0ii18 <br />Applicanl <br />�^ �''jTINf, ~-2�-s. <br />n� <br />PE�MIT <br />c.t. <br />r_r <br />ii <br />r�f.i pp GO <br />I_ bl fl fl f.J bl r:� �.`ni <br />.,1 R. <f C] fl .1 f 1 li l <br />ra �e rr� .o , n �_I <br />in , . � .n <br />r i .n � <br />. .... . . . _ ' _ _ _ tr'�. <br />Maihn<� Address <br />Atldress <br />�„n��Wo,"��,m,�. Q 35 � <br />eiaa oso� . 47771 S -- -- <br />�Lc Wo�Fe {ee <br />to�n� P�e : <br />Les�amm �•era,e S <br />-�� r_4alence o�o S 2� _ <br />fJ <br />1'J O r1 <br />;. Q : <br />.., r: .. <br />.. r: <br />� I`- C�ty L4 -.� Q] OZ� > <br />�a e� �a � �, r�'� l.�i�� �. <br />O r^ IJ :1 �.p :1' " � 1 U �y p L) <br />O., rii r.t (] U F�� �i f. G i A IJ <br />Y� fl i u Y.� Ol Ul tll �tt �{ Y[ U) � I t <br />Gily <br />Dnscribe Proposed Work Nnv hm�pn _ ��; <br />302 74th St SW <br />Project Address pl known) <br />Lot 15 <br />Atlach four I�) copies ol plans lor proposed wo�k • praw to scale antl nolr the lollowing as applica6le <br />• Proper�y LineS <br />• Oulline and dimensions ol all ezlsfng and <br />proposed s(ructures on the lot <br />• Exisling and p�opoaed ulillties <br />• Cen�erGne ol street <br />• Intlicale North <br />• Show any proposed grading chanyes <br />• Show measuremenls <br />rnone <br />PERMIT CONDITIONS <br />I. All calls for Inspection shall be mede 24 hrs. in advance • phone 259•8810. <br />2. All work ahall be peAormed in eccordance with Ihis permil and cwrent City ol Everell Design anu Constiuction <br />Slanderds and Specllications. <br />3. Cell Location Jnderqround Service 48 hrs. before you dig. TOLL FREE NUMBEH 1-800•424•5555. <br />1. In�l�ll rock con�tniction enhance bclund dii��ewa}� as per cily standard �+2i�8 and crosimi control as dircded 1 <br />1'ubhc Wo�ks Inspec�or. <br />`. }:ccp cil�� ;hccis dcan at all luucs. <br />r; ('urb guttcr nnd sidewnik in thc pint nrc new nnd undnm�p:d. mry darn�� e Ihereto shall hc rcplaccd .0 thc <br />disacliun uf tlin Public '�vo�ks inspccloi. <br />'. Airy ch;m� c in thc drivca;�� cul mu�t be :ipproveA hy thc i`R� Insp:ctor. wid11: at prop I�ic lirtiiled lo exieti�, <br />npron widlh. <br />S. CwL lact drains or otliei stonu diain .tubs h,i�'c been pru�iJ�d lo taeh lo! o� tli� plat !or Ihe eo�meelion of <br />rootlop doK�n�po�rts. <br />__��� l%% �i� ?�Z3/95 <br />Approved foi Co,r slruclioD � Date <br />��� ��j • �� <br />RNAL INSPECTION Date <br />Appwved as Construded <br />� PIIBLIC WORKS DEPARTMENT <br />'V�3200 Gedei Stree� <br />Everelt, WA9tl201 <br />Phone: 259�8810 <br />ACKNOWLEDGEMENi OFCONDITIONS <br />W <br />� <br />� <br />� <br />� <br />The. undersigned owneVapplicant herebv agrees to hold and save harm� <br />less the Gly ol Everell from any and all claims lor dama9es, costs. <br />e.penses or causes ol aclion thal may arise because of installa�ion <br />and maintenance ol Ihe Imp�ovement or other ngh�-ol�way usc hereto <br />anni�P� �o� and �urthe� a9ree5 lo remove same upon noUce Irom thc� <br />Cdy and to replace pubhc property Jamaged thereby. <br />� ' �/ �i e,_. �—. <br />Signatwo ol pplicanl Dalc <br />WORK AUTHOF12C-D BY TfiIS PERMIT MUST BE S7ARTED WITHIN <br />iB0 DAVS OF DA1E PERMIT IS ISSUED AND iHEREAFTER IS TO <br />�E �ILIGENTLV PURSU[D TO COMPLETICN THIS PERMIT MAV 8[ <br />CANCELLLD �1' TNE UTY UPON ANV STOPPAG[ OF WORH ON THIS <br />PROJFCT OVG17 90 DAYS DURATION <br />