Laserfiche WebLink
'pcoad r/ese <br />Anldh.seo� i a, <br />'PUBLIC WOP:(S PERMIT <br />Print or Type Only,! 8 g <br />Describe Proposed Work <br />hqc WMI hrmr • � `O`' <br />Ties oni . <br />iqN 111 <br />1W 41oiIn hC{�L..�� ' <br />Zip Phone <br />Project Address (if snownl— <br />W <br />Attach lour 14 copies of plane for proposed work • Draw to scale and note the following ak applicable <br />• Property Lines • Cenlerline of elreel <br />,A <br />• Outline and dimensions of all existing and • Indicele North <br />v, <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />Y <br />W <br />DO NOT WRITE BEL W TMIS LINE <br />O <br />PERMIT CONDITIONS <br />1. All calls for Inspection shall be made 24 he in advance- ohone 259.8810 <br />ass') <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 />a Gil Location Underground Service 44�8 bra before you dig TOLL FREE NUMBER 1 •SOO.4243555. <br />y �-�I "! 177,r7 V loie�ld <br />L <br />O <br />Ipproved as Constructed <br />WORKS DEPARTMENT <br />CLPUBLIC <br />0200 Ceder Street <br />Everett WA 99201 <br />Phone'25?BB10 <br />d <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ovemp/appllcAnt hereby agrees to hold Ind save harm <br />less the City of Everett from any and all claims for damages, costa <br />expenses, or causes of action that may arias because of Installation <br />and maintenance of the improvement or other rlgh4ol-way use hereto <br />applied takeit lurth greed to remove same upon notice from the <br />City source loll property damaged thereby. <br />I <br />i lu a ofApPlfcW Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORN ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />