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ry <br />��� PUBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425)257-8810 <br />OWNER NAME ,. - , r= ,,, rw APPLICANT NAME <br />AND ADDRESS: ��'' �'+�'y' � d��'`-='=`� �� st;s_ ���c.'i':s AND ADDRESS: <br />t �Ei�`TFs�;�".:�7i�`��.: Z�#'; <br />�:� s?T.��.x r;s ��.<<�;:':3 <br />PHONE: <br />TAX PARCEL I.D. It <br />I��i ��•;?. �} �;ytt.,_�;fi <br />DESCRIPTIONOF .�_.`I���l� T'=°LI=.t�`:+ :����.�"F: <br />PROPOSED WORK: <br />PERMIT CONDITIONS <br />PHONE: <br />PROJECT ADDRESS: <br />D; <br />Public Works Permit # <br />Building Permit # <br />Planning Reference # <br />Public Works Fee $ <br />C 4XY1 � �`.. <br />._ . . ;�:�:' _'���:,:� �.;. �d,`.:t;w� �s,:<',t <br />,� <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 />'�. :Rr..' �'.i:L. :z(::��L'r:3'4�*'�;� �F.ii�'tk: ���.�t'-�.:;..:� _ ..—;.{u- �I3+:1 �}lx� ��+El�.��.:�i� Tad':.a..:�::: ll,�::�j:._�:�1F,�.Y>�:.. ' ..=¢��..°�. _.. � <br />L.t �. Y. :•'r t:7iF :. i'? �.�::. <br />L 1.Y�,�{� e _ <br />'!`4 �/ / <br />� .. � -�c ..� �. �, i .-r � F--1 M <br />W <br />- �; ��;�= � <br />;: � — C.i. G-.� <br />V Y — � <br />� ' ':.` �i r:''? :__ � . <br />TO POST��G 21�7/�� � .�:. � <br />�-.;-, <br />� �ns c,fiov� app►�v� �( �.�: _ 1 � <br />�; � G1 ( � � �, � r_— --� ':�-� �::, V ♦ <br />�p CL �f-� L���dvn Q'� �� � w �. ._ ._ � � : O <br />�;�,-�-� h zr{-�� -wi,at ���=� � <br />� 221�t��. _ <br />• � � rn, r�veV►� e.�lf5 (�XQ S�i�is��.�{o <br />� �-t P : � <br />� f <br />� <br />,`tf �: _- .-� r �_,,,... <br />,:(f"��.�:i'i�' �m:.�'" �,�'`G��'�..i <br />Approved for Construction � Date <br />FINAL INSPECTION <br />Approved as Constructed Date <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 />�,��-i „' "�� - . .. . , ._ <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 />