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. �� <br /> PUBLIC WORKS Date <br /> PuWic Works Permit M -a'� �- - - <br /> PERMIT Building Permit x <br /> PUBIIC WORKS DEPARTMENT Planning Referente p <br /> 3200 Cetlar Sireet <br /> Everetl,WA 98201 Public Works Fee S <br /> (425)257-8810 � <br /> Guarantee 3 <br /> OWNERNAME APPLICANTNAMc —p � <br /> ANDADORESS -�� ' �. - � ANDADDRESS: �AN � 8 ZOOy <br /> ,_ - r`� ���TIIVG A0°�Nvr <br /> PHONE: -, . PHONE: <br /> TA%PARCEL I.D.N PpqIECT ADDRESS: � <br /> p <br /> DESCRIPTION OF <br /> PROPOSED d/ORK: ' � ' ' , <br /> � <br /> I <br /> I <br /> PERMIT CONDITIONS � - ' � <br /> 1. All calls`or inspection shall be made 24 hours in advance. <br /> 2. A�I work shall be pertormed in accordance with this permit and current Ciry of Everetl Design and Construction <br /> Standards and Specifications. <br /> 3. Call LocaGon Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-4245555 � W` <br /> r <br /> /�� <br /> . `- . ` -- `� - . ..: ;:� _ . _. �,. - . V� <br /> �- -- _ ...�: rt.�:? a ��t;rs c �:;t �_i ie�r_�=.�. _ - _ _ . . ._. ... . - <br /> - :-g: i r �•�IPa 1 .i i t t eS 2�'.v t 1 . i'�-"�.i�.1 )S �.. ' . ' - .. � <br /> . i <br /> JV .-r!U TL ..`.� ?t� /3 � � ir ,P it . f �.Aj ' .wvl n t�ht TF,��i1, j7 i � . <br /> -,1�r ..i -.� _F.:{ > � _i �.�, 'F .m -r i�-�- i�' O <br /> _ . ' _ ... . . _ � 'T �. '� <br /> __ . .._ .-:.. , . , _ _ . , *. .;': . :,- .:: =c: F�srxr�i: ' � <br /> - � <br /> O <br /> 1 = � <br /> �j z u - ,w <br /> - ' - ' ;<. - V� <br /> ; - _ . .. O <br /> a <br /> . ACKNOWLEDGEMENT OF CONDITIONS <br /> , The urMersigned owner/applicant hereby agrees to holtl antl <br /> �_`I/=, --;;y�•`.� _ � �l ;, save harmless the City of Everett Irom any enG a11 claims tor <br /> ror Consm,aion ata damages,costs,axpenses,or causes of actbn Met may arise <br /> � tecause of installation erxl maintenance of the improvement or <br /> � - �.- ', - - . other righ4of�way use hereto epplied Por and furiher egrees to <br /> "�l% . _ --7�. ' � -�� . � _ remove same upon rwtice tran Me Ciry and io replace public <br /> ��NQ1�1 S�PECTION ' -` P��1�Y tlBmegBQ,M1B�eby. <br /> ' /(ppoved a9 Constructe0 Date T _ : '-_ . . <br /> - r '7 <br /> j� `�L , , . ; ., - :.. :�. i ....�_. y��(� i <br /> .._-_-_ - $ignalura oi Applicen� � Date� � - . � /. / <br /> NpRK AUTNORIZED BY TMIS PERMIT MUST BE STARiED WI?MIN 1B0 DAYS OF DATE PERMIT IS ISSUED RND THEREAFfEq IS TO BE DILK'iENTLY%1RSUED j //// <br /> TO OOMPLE110N.THIS PERMIT MAV 8E CANCELLED BY THE CfTV UPON ANV STOPPAGE OF N'ORK ON THIS PRQIECT OVER 90 DAVS DURATION. u <br /> EPVYP(]�1 DAT�R.IHC <br />