Laserfiche WebLink
Date 6/7/83 <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Same <br />Mailing <br />Describe Proposed Work <br />City <br />City <br />Bubb, Warts FenNt a <br />Bldg Dept a 83/12050 <br />PublieWmxFFee ?�%! <br />Total FOR <br />Leet xppt Fee Peid <br />ice! <br />Balance Dus <br />Project Address (if known) <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />•Show measurements <br />• Existing and proposed utilities <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. In advance - phone 259.8815. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 his. before you dig. TOLL FREE NUMBER 1 .800.424.5555. <br />everett PUBLIC WORKS DEPARTMENT <br />Slier! <br />Everell %NA 9920' <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Cl/ <br />ca <br />0 <br />Bal <br />0 <br />Cl)M <br />Y <br />0 <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, costs. <br />expenses, or causes of action that may arise because of Installation <br />and maintenance of the improvement at other right-of-way use hereto <br />applied for end further agrees to remove same uc n notice from the <br />City and to replace public rop rty damaged therecy. <br />81'gnature of Applicant <br />Date <br />WORK RMIT MUST BE STARTED <br />B0 DAYS OF OFDATE PERMIT IRIZED BY "IS S WITHIN <br />ISSUED AND THEREAFTER TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER g0 DAYS DURATION <br />