Laserfiche WebLink
PUB�i�woRKs <br />OWNER NAME <br />AND ADDRESS: <br />:t PVI:i I <br />PHONE: <br />TAX PARCELI.D.# <br />DESCRIPTION OF <br />PROPOSED WORK: <br />PERMIT CONDITIONS <br />PERMIT <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 />• <br />Public Works Permit # <br />Building Permit # <br />Planning Reference # <br />Public Works Fee $ <br />Guarantee $ <br />�M1,���i--u1a <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 />� . ; .:: , :: _ . . .: :. _ : ;. > .,. . •: u� �� , <br />L, 'T'; �r.,t,;;'?'+t.� .,pa-; +, �a , ; ps •� -„':. <br />Approved for Co struction Date <br />e��' r y �—� — � <br />FINAL INSPEC ION <br />Approved as Construct d Date <br />� � � � <br />F Eg 0 2 2005 <br />o� Se ER� TT <br />� <br />������tr <br />ACKNOWLEDGEMENT OF CONDITIONS <br />� <br />0 <br />� <br />� <br />� <br />a <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 <br />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 />