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` ' PUBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />�42�' � � �9��a ��j1 � �Q��i <br />� � ���� _.__ _.._.__-- — <br />OWNER NAME J<�?R�aEA}'.:EN 3-:OBIN <br />ANDADDRESS: l�l� r:�::�'�FELLEF; <br />E iiERETT' r:3.'�: <br />PHONE: ��:S�F�.�i�.�:� <br />TAX PARCEL I.D. # i� �� � + ; Q� `' �.i :� �.1 ,' :` .i <br />DESCRIPTION OF y � �� �� � � �1 <br />PROPOSED WORK: <br />PERMIT CONDITIONS <br />APPLICANT NAME <br />AND ADDRESS: <br />_ _':�:� <br />PHONE: <br />PROJECTADDRESS <br />Date <br />Public Works Permit # <br />Building Permit # <br />Planning Reference # <br />Public Works Fee $ <br />Guarantee $ <br />-L <:: ._ _ :�:C�_ "..0 ���. .:Y,: . . , . .� <br />�r� 17i���o; <br />F•iaT0505-020 <br />�.�0505-p12 <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 � � �.�...r G�i-Q l✓J_.t.J�� <br />4 _+nr:�,� ._ + _;Zr'=_ '�i�_.k>�'.S::�it�il�tS '':� �t:t •- .. _. . :. . . � . ...._z. _ � �.. _ � . <br />�iS�,tM�E �/�V/�Gls ��t/S/�E�-�ur2 �s ��"�1��'Ec-iE� <br />/J/� „� c� -7a ���� y p;�E �'�x��,G u/��nvx� _: <br />/YG ^/J �%� I ��. ,'�C � �/2 �/ �-i'� ` i r7�y :ST � � � .. <br />�� � � :' J �.� � �" f <br />�_:��� i� . ... .. <br />1�� <br />Cl��' �►N► �-f l�{ GS� (� -t- 33 L✓�� s dc; ,c� F� <br />� � <br />: �-�- E'.� .S j C^ S <br />r Construction Da <br />��..�..�' �/�/�� <br />FINAL INSPE <br />Approved as <br />Date <br />. ..���� �H:I� i"". <br />�i:?F r�..:a r'?i =�i• <br />�.:1 -r-rr_![:.a[.:n <br />�' 7'� u i•s .:K.� _.1 ;.`i"i <br />.: "i �.�. 1 .:.."� i;.r'1 rti. '�.. �. <br />� ��`. <br />��� ::1 � .J C..:� .... + F•�Y <br />4. � •__ <br />��_ . ;r>. <br />/ <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigne,d own /applicant hereby agrees to hold and <br />save harmless'the Ci�of Everett from any and all claims for <br />damages, co 'ts, ex �enses, or causes of action that may arise <br />because of i Ilallon and maintenance of the improvement or <br />other righ't-o ay�Gse hereto applied for and further agrees to <br />remove:Sa up¢n notice from the City and to replace public <br />prope am g�d thereby. <br />/ � s .� <br />� /' � ,-� •,��� v'i / � � <br />� v <br />Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSU AN THEREAFTER IS TO BE DILIGENTLY PURSUED <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WO N T S PROJECT OVER 90 DAYS DURATION. <br />