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�� ��J��1� t�l��.11�� P'���1�' <br />�� .�"`�,,�r�' _ -- City bfi �ver�tt P��bli�� W��il<:�; C)e�<�rti7uai�l: <br />.�r-� 3-.� ,e`ar ic�t� <br />y�=�i�5d7 <br />Ev�reft, Wr� ���1C�'1 <br />(425) 2�7-f381 C� <br />u.�t� <br />f'iil�lii; W�rh� F'�t'ir�it #: <br />---��i�il�iirr� P�rr�it�#; <br />k'I�n��ii�q i��f�r�nc� #: <br />�i/7/�01 � <br />F'W1 �i�5 U(�6 <br />F'�ik�li� 1Nr�rks F�e �: � 2�.CJ(� <br />Ottier $: <br />OWN�R NAME AN� ACIDRE�S: APF'LIC,4N7" NAME AND AbbFtESS: <br />CI1�Y OF EVERETT FH�NTIER �'.(�MMUNILATIC)NS <br />3200 CEDAR ST 1�3C)(J 41ST :�l7MC;W/�C)1��1U3 <br />EVERETT WA 98201 �V�.HE_TT W� �F320�1 <br />PNONE: PH(�NE: �}�5?Ei3�8�() <br />�_.--.. ----------- ----- ----- <br />-----------_ ----.. <br />TAX PARCEL ID # SITE ADDRES5: 3;3Q4 C3F�AND AVE. <br />DESCRIPTION OF PROPOSED WORK: <br />REPLACE POLES. <br />PERMIT CONDITIONS <br />1. All calis fior inspection shail be made 24 hours in advance. <br />2. All work shall be perfiormed in acccirdance with the perrnit and c�irrent �ity of Euerett besign and Constr��ction Stand�rds <br />and Specifications. <br />3. Call Location Underground Service 48 hrs befiore you di�. TOLL FREE NUMBER 811 <br />4. Contact City inspector Randy Allen (425)339-7403 prior to starting construction. <br />5. Do i�ot block all�y access. <br />6. Put consiruction sign at least 24 hrs prior to construction. <br />; ��, <br />�r,� , '� <br />� ., �> �,� "�, y:�- <br />�ved for Constfu�tio� n — <br />FI�/OL I�ISPECTIOfV <br />Approved as Constructed <br />Date <br />Z�, � �'`�._ <br />_ . '-� ! -�. i <br />t <br />�l?,�1Y �. 5 2 G i 7_ ' <br />� <br />�'�Ty t��' �:�j° <br />����„', <br />ACKNOV\iLEDGEMEf�T OF CONDITIONS <br />TI1e 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 iilstallation and maintenance of the improvement <br />or other right-of-way use hereto ap��iied for and further agree� <br />to rernove same upon notice from the City and to replace � <br />pu lic property damaged thereby. <br />.�-��� <br />� � <br />Signature of Applicant Date <br />WORK /�UTf-VORIZED BY TI1IS PERMIT MUST BE STARTED WITNIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEf2 IS TO 6E DILIGENTLY <br />PURSUED TO COMP�ETION. THIS PERMiT MAY BE CANCELLED BY TIiE CITI' UPON ANY STOPPAG[ OF WORK ON THIS PROJECT OVER 90 DAYS DUR/�TION. <br />