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PUBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />Date <br />Public Works Permit # <br />Building Permit # <br />Planning Reference # <br />Public Works Fee $ <br />Guarantee $ <br />9/19/V006 <br />PD10609-01s <br />$255.1 <br />4 �- <br />OWNER NAME APPLICANT NAME <br />AND ADDRESS: ALFORD jEFF AND ADDRESS: FEEL, :H < HATT <br />24 194TH S T NNI 986 14ICBAE1L PAY <br />ARLINGTi IN VIA 98223 CASr11 f ISLAND WA 98292 <br />PHON 4252381363 - PHONE: 3609290413 <br />TAX PARCEL I.D.# PROJECTADDRESS: <br />0057360i�i.7037Cs2 11224 211R1 A:E 5E <br />DESCRIPTION OF <br />PROPOSED WORK: SHORT PLAT 1101P'_W.TTE7 i!s?FrS — z 2 6. 3 Ei — <br />12t)2.{ 02, a 0(0 <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 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. Construct per attached and caarke—d :approve-d. drawing <br />L'•:) ',• rn <br />cr) e" <br />pzj, <br />CII�� =i <br />r�l <br />rr7 <br />=1 <br />� ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and <br />1 ! 12­7' rq save harmless the City of Everett from any and all claims for <br />f damages, costs, expenses, or causes of action that may arise <br />,pro for Constiucti n Date because of installation and maintenance of the improvement or <br />EP ��� other right-of-way use hereto applied for and further agrees to <br />`��/ remov same upon notice from the City and to replace public <br />L INSPECTION pr a damaged the eby. <br />Approved as Constructed Date > <br />S' of A t 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 />EPWP (7/06) DATABAR, INC. <br />W <br />U) <br />Im <br />0 <br />003 <br />0 <br />0 <br />0 <br />a <br />