Laserfiche WebLink
oeia3� <br />qpplicallon For <br />PUB�IC WORKS PERMIT <br />Print or Type Only <br />Owner <br />Mailing AdCress <br />Mailing <br />PuEI¢ 1Yorh� Perpmit !• , �"'� — � <br />eiau o+o�. • —p,7�� � �- — <br />/ <br />runuc Worh� iae <br />toui�ee � — <br />Ien�oo�FeePUE S— /� <br />pninnce Oun S � ^ `�O <br />7s9.ab <br />c�cz�err_�f��1 3 _Fs.�-�/�s Z <br />� Zip Phnne <br />City .. Dp Phone <br />DescrlbeProposed Work /NS��'" as W/%�� �n��RCs�r �� (/Ewl��y _ <br />Prolect Address UI knownl ..7/�� —� r '7 .� � ci— <br />Attech lour (4) coples of plans for pruposed work • Draw to scele antl note thc following xs applicable: <br />• Property Llnes <br />• Outline and dimensions of all exisling and <br />proposed structures an Ihe lot <br />• Existing and prOposed ulllitios <br />• Cen�erline ol street <br />• Indicale North <br />• Show any propoaed grading cnanges <br />• ShoN� meesurrments <br />{'ERMIT CONDITIONS <br />1. All ca�ls for inspectlon shall be made 24 hrs. in advance - Phone 259•88� 5. <br />2. All work ehell be pPrformed In eccordance wilh this permlt and cwrent City ol Everelt Design and Consiruclion <br />Slanderds end Specificatlons. <br />3.�Cnll location'Inderground Service 48 hrs. belore you dlp. TCLI FREE NUMBER �•800•424•SSrJ5. <br />. � <br />. „ � n�n� ��:5 9� <br />Approvod ior Conshuction" Dete <br />(X� �� 7-'�'� <br />FINAL INSPECTION �`�1e <br />Approved as Constructed <br />c�errtt PUBLIC WORHS DEPARTMENT <br />�3200 Cedur Slreet <br />Everett. WA 98201 <br />Phone�259�8815 <br />�CKNOWLEDGEMFNT OF COM�ITIONS <br />� <br />O <br />Thc unticrsynrd ownei/apFlicant hereby ugrees to hold and s��-e harm- <br />Iess the Gdy nl Eve�r.it Irom any xnd all elaims lor dnmages, costs, <br />expenses, or causes ol action that may arise becnuse of Inslallatiun <br />and mainlenance ul Ihe improvemenl or other right�obway use h�relo <br />npphcA tor anA lurther ayre 5 lo removP same upon no�ico Irom ihe <br />Citv�cTTO`ceP��r.e publiC �Pertv damaged Ihereby. <br />�-����'s <br />WpRK AUTHORIZED 6V THIS PERMIT MUST BE STARTED WITHIN <br />160 DAY5 OF �ATE PERMIT IS ISSUED AND THEREAFiER IS TO <br />BE DILIGENTLV PURSUED TO COMPLE710N. THIS PERMIT MAY BE <br />CANCELLED BY 1HE G7V UPON ANY STOPPAGE OF WJRK ON THIS <br />PRCJECT OVER 90 DAVS DURATION. <br />