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� <br />� <br />PUBLIC WORKS <br />PERMIT <br />OWNERNAME <br />AND ADDRESS: <br />. L � : i:�: �J ' <br />PHONE: <br />TAX PARCEL I.D.# <br />DESCRIPTION OF <br />PROPOSED WORK: <br />PERMIT CONDITIONS <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425)257-8810 <br />APPLICANT NAME <br />AND ADDRESS: <br />PHONE: <br />PROJECTADDRESS: <br />Date <br />Public Works Permit # <br />Building Permit # <br />Planning Reference # <br />Public Works Fee $ <br />Guarantee $ <br />_ i''i.�ii ii Ti�, `�� J. L ori L_ <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 />. . 1-:c�,�i�t��C L"E':GuVc�a ��;Y Cr,VE:.Y=�'1 �>�i+c7fi•. <br />b. PtovidFy the tte�-�,c:�ry ttaffi�� s��{:.� ;;;;, �_-L:l..t���._s. _. �t2�.a:. <br />, _ . ;, i;�. <; i..::r "_ -. <br />7. Han� c„�t nc�ti�_�e� rc� th? �E�rrc��;n�.}in:� busi.ne::s�s nf the �i,:��:-, <br />�. ?i�7L'Fr� tq L•131ri�:�1I1 GL �! �IQ�?Tlr ;.ZIl�� G�?�;�i3GF_+ 4)ltf� 7t;3t4��'3L'�� 1 <br />rubr�e�•z��� as�.tih�lt m�tvri�l faii Wi�.ni:� �_f= , <br />,. . , <br />.. . . .. ,, ; . ,i . .. , ., ,1 , ;_. f' +- t - g ;: ... ,. - i - � • <br />Yfy.'�����1�.?�,�' """.�� Lf � �{�,9 <br />C� <br />Ap �or Construction D e <br />,� s .,� � � <br />FINAL INSP ION <br />Approved Constructed Date <br />n� <br />�� � `� <br />� �� <br />r ,�,�i� �' <br />v <br />� <br />( �-+�', ,%t ,^', �' - <br />a�Fa s �-��-��� <br />5 �``.� <br />� � � � <br />AU G 0 9 2006 <br />CITY OF EVERETT <br />ecmtt Serv�ces <br />ACKNOWLED�EMENT 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 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 />� I� . ._ , <br />..,- . , � ' ��; � �� . ��� <br />� � --- -- �� _ — __ <br />Signature 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 />