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Date 12/6/2005 <br />PUBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />PNO512-004 <br />Public Works Permit # <br />Building Permit # <br />Planning Reference # <br />Public Works Fee $ $0.00 <br />Guarantee $ <br />OWNER NAME— --'S'`5"3jz APPLICANT NAME <br />ANDADDREK,.17 124TIi ST SE AND ADDRESS: <br />EVERETT 13A 98208 <br />PHONE: 4253304361 PHONE: <br />TAX PARCEL I.D. # 1 PROJECT ADDRESS;=0 2-4 3 t :e- <br />DESCRIPTION OF <br />PROPOSED WORK: <br />PERMIT CONDITIONS <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. SENER AND TRATER ONLY PER, SILVER. LANE PLAT+IS <br />Approved for Const ction Date <br />INSPECTION <br />Approved as Constructed Date <br />y <br />U [E <br />DEC ® 6 2005 <br />CITY OF EVERETT <br />Permit Services <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />Cn <br />in <br />O <br />z <br />O <br />�F- <br />V♦. <br />0.. <br />a <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`Sf Applicant Date <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 />