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PUBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Straet <br />Everett, WA 98201 <br />(h25)257-8810 <br />rOWNERNAME <br />ANDAD�RES$:;,-,P,�l' �',:' F,VF.Nl.:: <br />PU RUX 5"?B <br />!:1�E;RE7'f <br />PHONE: 9_ y� 5 jl :i j G:'� <br />TA%PAI�CEL IA.M <br />kTA q3:.�)•� <br />Date <br />Public Works Permil N ` � � � � <br />Building Permit N <br />Plannin9 Relerence # <br />Public Works Feo 5 �� � - <br />Guarantee S <br />APPUGAN1NAMt , <br />AND ADDR[SS: <br />—_ eIRST _. � �:. -`�.'q <br />. _.. -'1'LE �r:, _ :�:.1 � � <: <br />PHONE: .��, i.:,.:;LJ:7 <br />PRQIECTADDRESS ��� � t��,�;� t�':, �� . �,?' <br />DESCRIPTION OF <br />PFOPOSEDWORK�J�!��,rTSP1AN DISTFI� tFPIbITY S SI7'E llar`'�'."1�:`r,ti'P:; <br />., ,. , .�r� ::rrrr.n; t�;:9 .: RC,>.�r u.1�;, .-,;�,�. <br />PERMIT CONDITIONS <br />1. All calis lor inspection shall be made 24 hours in advance. <br />2. All work shall be perbrmed in accordance wilh Ihis permit and currenl City ot Everell Design and Conslruction <br />Standards and Specifications. <br />3. Call Lxation Underground Service 48 hrs. betore you dig. TOLL FREE NUMBER 1-800-424-5555 <br />, � • ,• i .a r.•, .:., <br />,. <br />� ,, � .c -_.!. ,. _� i ,: - . . ., . <br />Land.caninj shyii be dene yeL }�lans apc, :. � .. F <br />„dscauina plan� must be appc�avwi peinr t� � •� • <br />niired a landscapinq m«licicatYon appco�: <br />��� I/y� � '• / <br />�. � � , ��M" y��` ( <br />App �c r Constructio�/���v" � <br />G A � �� 1 <br />[ <br />FINALINSP ION <br />Approved a Constructed <br />Date <br />� <br />� <br />N <br />W <br />O <br />Z <br />O <br />� <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant he.eby agreos to holtl and <br />sava harmless the City ol Evorelt from any and all claims lor <br />darnages, cosls, expenses, or causes ol action that may arise <br />Uecause ol installation antl maintenance of Ihe improvement or <br />othei right-of-way use hereto applied for and lunher agrees to <br />remove same upon notice Irem the Cily and to replace public <br />propchy damaged thereby. <br />�,. <br />�I. � . . ��._ . � . - _ . <br />SignaWroofApplicanl Dato <br />70 COMPLET�ION T�H SVPERM T MAV E CANCELLED �Y�THE CITY�UPON ANY�510PP%GE OF WOFK ON THIS PROJEC OVER O�DAVS'DUR TIONPURSUED <br />DATA�AR. INC <br />[P1YP 11:OG1 <br />