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N PUBLIC IRKS PERMIT <br />City of Everett Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />Date: 5/11 /2009 <br />Public��V)C)rks Permit #: PWO905-011 <br />Buildinq Permit #; <br />Planninq Reference #: <br />Public Works Fee $: $ 583.32 <br />Other $: <br />OWNER NAME AND ADDRESS: <br />APPLICANT NAME AND ADDRESS: <br />BUI THUVAN T <br />same <br />24 113TH ST SE <br />EVERETT WA 98208 <br />PHONE: 4253442207 <br />PHONE: <br />TAX PARCEL ID # 00573600003401 <br />SITE ADDRESS: 11316 2ND AVE SE <br />DESCRIPTION OF PROPOSED WORK: <br />SHORT PLAT-1202-2008-003 <br />1 3/4" water service <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hours in advance. <br />2. All work shall be performed in accordance with the permit and current City of Everett Design and Construction Standards <br />and Specifications. <br />3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br />4. Construct per plan. <br />--1 •F'� �- T " �J Ti <br />;'i <br />u' q <br />1 <br />••ram-7 <br />""> O <br />� <br />Gd <br />Tj` <br />,u!t <br />ly` <br />y <br />4sr, *r' <br />m�¢a�n�� r•.a�� <br />r•.D <br />c> <br />ice. r•.� <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 <br />or other. right-of-way use hereto applied for and further agrees <br />to remove same u n notice from the City and to replace <br />public prop ert <br />a ged thereby. <br />S-lac) <br />Signature of Applicant <br />Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br />PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />