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PUB�ic woRKs <br />PERMIT <br />PUBLIC WORKS OEPARTMENT <br />3200 Cedar Slreet <br />Everen, WA 98207 <br />''25,25'.`�P pOSTING FEe 1 s <br />OWNER NAME <br />ANDA�DRF��E MINNZE <br />1931 W MUKILTEO BLVD <br />EVERETT WA 98203 <br />PHONE: <br />(425)355-2981 <br />7A%PARCELI.D.w <br />OOQ17100004702 <br />DESCRIPTION OF <br />PROPOSED WORN: TWO ANTENNAS <br />0 <br />PERMIT CONDITIONS <br />APPLICANT NAME <br />ANDADDRESS: <br />PHONE: <br />PROJECT <br />oe,e i�zz,zooi <br />PublicWorksPe�mRN Pwoioi—ois —� <br />Building Pertnil N B0012- 02?. <br />Planning Reference N � � <br />i <br />Public Works Fee 3 $ 3S.iT0' <br />Guarantee $ <br />1. All calls for inspection shall be made 24 hours in advance • phone (425) 257•8810 <br />2. AII work shall be performed in accordance wilh this permit and current City ol Everetl 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 public works approved plans (�heets a-1, a-2, a-3) dated <br />1/22/00. <br />5. Install erosion control as per the pubic works inspectors directions <br />in the field. <br />O1-'�6-v� 1i:0�AN <br />�i aoiza.� <br />BUILD 581.�� <br />SRCHG 4.�0 <br />N U101018 <br />OiNER 45.00 <br />i01AL ti�0.i5 <br />�i-:EF: <br />Iv!-IEl-: <br />CHANf;E <br />A 0"1�0� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />N <br />W <br />O <br />� <br />Z <br />� <br />'�A <br />V/ <br />y%:00 <br />Sb�l�75 <br />0,00 <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless the Ciry of Everetl irom any antl all claims lor <br />damages, costs, expenses, or causes of action that may arise <br />because of installation and maintenance ol the improvement or <br />other righ4of�way use hereto applied lor and further agrees to <br />remo same upo otice irom the City and to place p blic <br />prop damaged h eby. <br />SignaWre ol A{p k, t Date �� <br />WORK AU7HORIZED BY THIS PERMIT MUSt 9E STAF7ED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAF7ER IS TO BE OILIGENTLY PURSUED <br />70 COMPLE710N. iH15 PEPMIT AtAV �E CANCELLED BY THE CITV UPON ANY STOPPAGE OF WORK ON hil5 PROJECT OVF.R 90 DA\'S DURATION. <br />