Laserfiche WebLink
� � � fnC/�,�`,� J -19-R9 // � <br /> [� �. .' <br /> Date��Y/�y/ 7�' t v„ei�cwo�knr.�mn. �ln — 7�� <br /> / '. <br /> Application For �'�°Q o'0� • — <br /> PUBLIC WORKS PERMIT ��°°°°w°��,�°° -- <br /> ,o,.,F�� : <br /> iP.senoi.reeve�e S__ '�_ <br /> Print or Type Only � o.�.��>o�� a < < /— <br /> EVF.RETT NEUROLOGICAL CENTER 2320 Rucker Everett, WA 98201 259-5121 <br /> Owner Mai{ing Addre55 Gity Zip Phone <br /> NEWLAND CONSTRUCTION CO. . INC. P. O. 13ox 958 Everetl, WA 98206 259-9191 <br /> Apphcani Malling Atldress f,lty Zip Phone <br /> Describe Proposed Work New concrete driveways and curb cuts }'or doctnr's office and clinic <br /> W � <br /> Prolect AOdress lil known) 2326 Rucker Avenue Everett Washin ton � � <br /> Atlach tom(4)copies ol plans ic�r proposed work- Dtaw to scale and note ihe following as applicable: � <br /> • Property Unes • Centerline ol street � <br /> • Outline and dimensions ol all existing and • Indica�e Norih <br /> proposetl structu�es on Ihe lot • Sho�.v any proposed grading changes <br /> • Existing and p�oposed utilities • Show measurements � <br /> DO tJOT WRITE BELOV!THIS LINE O <br /> PERMiT COND�TIONS <br /> 1. All calls for inspection sM1all be made 24 hrs. in advance- phone 259•881 5. � <br /> 2. All work shall be perlormed in accordance with ihis permit and wrrent City of Everetl Design and Conshuction <br /> Standartls and Specilicetions. <br /> 3. Call Location Underground Service 48 hrs. belore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> T TC f�E CCJ?IST,e'�/�TEO /�E'�' �`�r�i'D)��O 7n[F�n/� O <br /> D.?TE.l� %O-/O-.'�'G' <br /> � <br /> 10/13/86 11:3� OOOGIM � <br /> i <br /> DPT.20 t^c81.30 � <br /> CHECf; 5281.30 <br /> ACKNOWL[DG[MENT OF CONOITIONS <br /> The underslgned owner/applicant hereby ag�ees to hold and save harm� <br /> less the Cily ol Everetl !rom any and all claims for damages, cosis, <br /> � eapenses, or causes ol ac�ion ihat may anse because ol installation <br /> �� �� �� and mainlenance of the improvement or other right-ol�way use hereto <br /> � � � apPlied lor and further agrees to remove same upon notice irom the <br /> Appr ed lor Con ,u tio / Date City and to replace public property tlamaged Ihereby. <br /> / / <br /> / <br /> �fl�t.� �-/U- �����i 1 Q • � (�,, � . <br /> FINALINSP TION Date 'rv�' ��'�`-�"�"' /O-/j-�6 <br /> Approved as Constructed Signature ol Applicant Date <br /> everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZ.ED BY THIS PERMIT MUST BE STARiED WITHIN <br /> 180 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200 Cedar Street BE DIUGENTLY PURSUFD TO COMPL[710N. THIS PERMIT MAV BE <br /> Eve.eH.WA 98201 CANC[LLED OY TH[CITY UPON ANY STOPPAG[OF WORK ON THIS <br /> Phone: 259-8815 PFOJ[CT OVER 90 DA15 f7URATION. <br />