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PUBLIC W�RKS PERMIT Dale <br /> PUBLIC WORKS DEPARTMENT Public Works Permit e <br /> 9200 Cedar Street <br /> Everett,WA 98201 259-8810 <br /> Building Permit Y <br /> TYPE OR PRINT ONLY Public Works Fee S _ <br /> Plan Check No: B 58554 SEPA <br /> Applicat.Date: 04/17/98 <br /> Job Addreae: 319 76TH ST M SVJ <br /> Owner Owner: CITY OF EVERETT Phone <br /> Tenant: WESTERN WIRELESS <br /> Proposed Use: CELLULAR ANTENNA <br /> Desc. of Work: _ <br /> Applicant TELECOMMUNICATION ANTENNA ON WATER TOWER Phone <br /> (SPU 5-97) <br /> Describe Proposed Work — OFFICE SET JOB SET <br /> APPROVED FOR PERMTT: DATE_/_/_ BY <br /> PROJECT ADDRESS (if known) -- M <br /> Attach four(4)copies of plans for proposed work-Draw to scale and note the following if applicable: O <br /> 'Property(Ines 'Outline and dimensions of all existing and proposed structures on the 101 "Existing and proposed utilities <br /> 'Centerline of street •Indicate North •Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: Z <br /> 1. All calls for inspection shall be made 24 hours In advance - phone 259-8810. <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and Q <br /> Construction Standards and Specifications. <br /> 3. Call Location I)nderground Service 48 hrs. befora you dig. TOLL FREE NUMBER 1.800-424-5555. <br /> CIO <br /> / <br /> O <br /> 1URan <br /> NOTOwRGi1UI[Rlli�1r <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to holy and save harmless <br /> the City of Everett from any and all claims for damages,costs,expenses,or <br /> Approved for Consiruclion Date causes of action that may arise because of Installation and maintenance of <br /> the Improvement or other right-of-way use hereto applied for and further agrees <br /> to remove same upon notice from the City and to replace public properly <br /> damaged thereby. <br /> FINAL INSPFCTION Date <br /> Approved as Constructed <br /> Signature of Applicant Date <br /> 'CORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEPJN.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />