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�us��c woRKs <br />PERMIT <br />PU6LIC VJORKS DEPAHTIdENT <br />3200 Cetlar Slreei <br />Evercit. WA 48201 <br />Id25) 257-8at 0 <br />ov�rdriaranr,�a`flb�N F,`:'" <br />A1JD ADDR[ S� <br />�..:Q FI}�� :i. <br />S �A'^� iE <br />PHON[ �1i�:9:E,�J4_ <br />iAxPARCELIDk;-, . <br />� o�.: �l� $')'. ' <br />PHONE <br />Oate , : _ <br />Pubiic WorkS Permit # _ •,- _, ; � � _ �� � .: <br />Buii�ing Peimit N <br />Planning Reterence u <br />Public Works Feo 5 <br />GuarameN S <br />ADD4±ESS <br />v,�C.: , . . - ...— <br />otscr�irlioNOF,:��h' "' - - r"' PT:L'i ..1��: <br />i�i�oros[nv✓on�� -.. � . _. .... . , . . ..._.� .. <br />PERMIT CONDITIONS <br />�;�r�4-02' <br />7. All calls lor inspec�ion shall be made 24 hours in advance - phone (425) 257-8810 <br />2. All work shall be performed in accordance with Ihis permit and curren� City of Evere�t Design and Consiruction <br />Standards and Specdic;a�ions <br />3. Call Location Underground Service 4f3 hrs. belore you dig. TOLL fREE NUMBER 1•800-424•5555 <br />Y. __ . :�CiT:. � _.. �...'. i ,...._ . ... - . <br />' - ��� `� <br />_.r CLI C' tC�—_7-� –G ' <br />APPr �-d lor niC��on di�o <br />�����.� �n7� � <br />,��.. ' ��I ���� ���I-c� <br />NAL � y'r <br />Appmced as ConsihA=la4 Date <br />�-. � r- <br />�r .��Jacn",ffi <br />� � 4-� <br />� c-, <br />� <br />ACKNOWLFDGEMENT OF CONDITIONS <br />The unders�gned owner apphcant hereby aqrees to hold antl <br />save hannless Ihe Ciry ol Everett irom any and all claims for <br />damages. c�sts. ezpenses. or causes of acLon ihal may anse <br />because ol mstaltrdion and maintenance of ihe improvement or <br />other nghl�of-way use hereto applied lor entl luriher .,yrees to <br />-remave same u n n� e from Ihe City and to replace public <br />pro�rtyZl ged t ;re y. <br />� . �-� S' _Z � � <br />S�gna�urc of Appbcant � Dale <br />`I-- -- <br />1VOHK AUiHpRiT_[P Bv iHl$ PFRfdiT �,1U57 OL SiAf1TfFD WITNIN 180 DAVS OF D�TE PEHMI7IS ISSU[D ANU THf_R[AFTER IS TO �E DILIGEMLV PUFSUED <br />lp pOtdl'I !-1 IOfJ 1HLC PCRldll IdAY PC CANGEI I CD L1' 7HE CIT1' IIPON ANV STOPPAGE OF WOFK ON THIS �'ROJECT OVCR. 90 �AVS DURATIGN <br />