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PUBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425)257.8810 <br />OWNERNAME 14Ul:ll AllleLll:d, 1LL1. <br />ANDADDRESS: 130 North Main Street <br />Butte MT 59701 <br />PHONE: ]PHONE: <br />Date <br />Public Works Permit a <br />Building Permit a <br />Planning Reference 4 <br />Public Works Fee $ <br />Guarantee $ <br />(406)496-5317 <br />TAX PARCEL LD.x PROJECT ADDRESS: 5413 S 21Td Ave <br />DESCRIPTION OF Install Fiber Optic Cable in Right-of-way <br />PROPOSED WORK: <br />PW <br />PERMIT CONDITIONS <br />10/26/2000 <br />PWO010-026 <br />$ 550.00 <br />1. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <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 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />4. As per terms and conditions of the "City of Everett Public Works W <br />Revocable General Permit Ljr Activity Wiithin the Public Right-of-way" <br />between the City of Everett. and Touch America, Inc. dated October 1.Sth, A <br />2000. V/ <br />Go <br />pproved for sWction Da . <br />FINAL INSPECTION <br />Approved as Constructed Date <br />�@ <br />10 26-00 12:09PH <br />O <br />0 001002E <br />OMER rZ0.; - BL <br />MM3 <br />TOTAL FA- <br />Z <br />`O <br />''r^ <br />Vi <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner'applicant hereby agrees to hold and <br />save harmless the City of Everett from any and all claims for <br />damages, costs, expenses, or causes of action that may arise <br />because of installation and maintenance of the improvement or <br />other right-of-way use hereto applied for and further agrees to <br />remove same upon notice from the City and to replace public <br />property damaged thereby. <br />Signature of Applkanl Dale <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />