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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 />OWNER NAME <br />AND ADDRESS: <br />PHONE: <br />TAX PARCEL I.D. # <br />DESCRIPTION OF <br />PROPOSED WORK: <br />PERMIT CONDITIONS <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 />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 />� . �r�ditional erosion ��ontrol measures �k�aJ_1 �� <br />�_ , . - - , - - � �. . <br />.�-� <br />.%'� <br />Approved for Constructior Date <br />j! 5 �w.� c9 t�'f N�, Gy �0��11'/GY� �� <br />FINAL INSPECTION <br />Approved as Constructed Date <br /># f�^cO1Gi: <br />OTHEfi �60. i, <br />TpTAL 560.4' <br />A 4M99�4 <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 />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 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 />