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CLEARING, GRUBBING, GRADING, AND EXCAVATION PERMIT <br />Type or print clearly in ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />Public Works PERMIT NO. <br />Everett, Washington <br />APPLICANT (Undersigned) AND FIRM REPRESENTED, IF ANY: — <br />HEREBY APPLIES FOR PERMISSION TO (Identify Quantities) <br />everett <br />FOR <br />OFFICE AT THE FOLLOWING LOCATION (S) <br />USE <br />ONLY <br />DETAILED, SCALED DRAWING OF WORK TO BE DONE, A I IAUN a write <br />ATTACH LEGAL DESCRIPTIONS <br />PERMIT IS VALID FOR 120 DAYS <br />(May be extended upon written approval from Public Works) <br />A NEW PERMIT IS REQUIRED IF WORK <br />HAS NOT BEGUN WITHIN 60 DAYS <br />THIS PERMIT TO BE POSTED ON JOB SITE. <br />CALL FOR INSPECTION 259-8811 <br />24 HOURS BEFORE BEGINNING OPERATION <br />PLANNING/SEPA APPROVAL <br />Approved for Construction (PWI <br />Issued (Bldg. Dept) Date <br />pproved as Constructed !PW I <br />G�MMM <br />till nn 1980 <br />... ......... ............. ....... I ....... <br />..,. <br />CITY OF EVERETT <br />u�,hlic Work, q'ot. <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages, costs, expenses, or causes of <br />action that may arise because of the clearing, <br />grubbing, grading, and/or excavation activities <br />hereto applied for and further agrees to comply <br />with all provisions of this permit. <br />Signature of Applicant/Date of Application <br />ess <br />City <br />Telephone Number <br />FEE <br />Zip <br />Alternate <br />