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. PUBLIC WORKS Date 7i 19,�[i��, <br /> PERMIT PUD1icWorksPermit# �w��.�::� :,�< / <br /> c_o�snF—��94 <br /> Building Permit e <br /> PUBLIC WORKS DEPARTMENT Planning Relerence a <br /> 320o CeAai Street <br /> Evcrett, WA 98201 Public Works Fee$ j i� ,;i�,; <br /> ��2��l�G Ut� i 8 �GG9 <br /> Guarantee$ <br /> OWNEPNAMESAAVER RI:�HARG/$ATHT'YN APPLICANTNAME <br /> ANDADDRESS:l�y .�5� S,t, �� ANDADDRESS� <br /> EVERETT wA 9t�2U3 <br /> PNONE `��5395:-8-;�1 PHONE: <br /> TAkPARCELIDa QU(juhjQOD003011 PROJECTADDRESS:,;�� �-n�; V.i. <br /> DESCRIPTION OF ' - <br /> PROPJSED WURK. <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance-phone(425) 257-8870 <br /> 2. All work shall be performed in accordance with this permit and current City d Everett Design and Construc�ion <br /> Standards and Specifications. <br /> 3. Cali Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br /> 4. _f d�_vn r � �t� a� !i -�Ca � " t.�:: � �la:hG� - , t.hev sh.ul -ot. De 1 .it.z=i on th= �` <br /> _as� sio.- :-• rhe ��c,i c*v i __a..�� . .-he si� � .-yrat_ 1�.a;r ,.. ._, ri�«- j-3ck r <br /> '�A <br /> V/ <br /> W <br /> O <br /> � <br /> Z <br /> � � � Q o <br /> � � 19 tioo5 � <br /> v <br /> � <br /> � ot'�s"��5 a <br /> ��.�Q��m�,. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> <, • � �, The undersigned ownedappiicant hereby agrezs to hold antl <br /> . L �/ save harmless the City of Everett from any;id all claims tor <br /> „ro�ea br���„tr�,ci�or, a�e damages,costs,ezpenses,or causes of action that may arise <br /> --% I because of installation antl maintenance of the improvement or <br /> f `� I i � �, �— other rigM-of-way use hereto applied F r and furiher agrees to <br /> r� "� � `��� ��-� r` �✓- � remove same upon notice from th � and to replace public <br /> FlNAL INSPECTION�� � property aged rebtis� <br /> Approvea as ConsCuctetl � Date - ��/ <br /> , — ���j(' <br /> S nalure of Appiicant � Date <br /> WORK 4UTMORIZED BY THIS PERMIT MUST PE STAP7ED WITHIN 180 DAVS OF DATE PERMIT IS ISSUEO AND THEREAFTER IS TO BE DIUGENTIv PURSl�FO <br /> �r�;p;,ipLETION THiS PERMIT MAY BF CANCELLED Bv THE CITV UPCN ANV STOPPAGE OF WORK ON THIS PROJECT OVEP 90 DAVS DURATION <br />