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bate 6/ 6/2 0 0`7 <br />PUBLIC WORKS. <br />Public Works Permit# PW0706-005, <br />N PERMIT • <br />Building Permit# <br />' PUBLIC WORKS DEPARTMENT <br />Plarining Reference # <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />Public Works Fee $ $5 0.0 0 <br />00 <br />Guap<tee $ <br />OWNER NAME <br />APPLICANT NAME <br />ANDADDRESS: Nilliam Rucker <br />ANDADDRESS: Same <br />8230 53rd Ave. IN.-- #A <br />Mukil.teo Ila 98275 <br />PHONE: 4253089639 <br />PHONE: <br />TAX PARCEL I.D.# <br />PROJECTADDRESS: ` <br />2320 Gale-121+ <br />DESCRIPTION OF <br />PROPOSED WORK: Short plat' #1202-10-07 <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 t-800-424-5555 . <br />W . <br />4. Construct per plan. <br />(n <br />:B�: <br />55 <br />' <br />4O4-I <br />• y • 'm7ii' ....f per_:, <br />LAI <br />Cn <br />a <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 />or o tru on ate/ ' <br />damages, costs, expenses, or causes of action that may arise <br />prov <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 />FINAL INSPEC I N <br />.Approved as S6nstructed Date <br />property damaged thereby. <br />7 <br />"5 gnature of 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 />\ EPWP (7/06) DATABAR, INC. <br />