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Date $/Z�/�001 � <br />� PUBLIC WORKS pWo1�6-�-�5 <br /> public works Pcrmit r <br /> PERMlTBuildmg Narmit M <br /> Plai�ning Roferenco N <br /> PUBLIC WORKS DEPARTMENT ,�j�0. 00 <br /> 3200 Cedar Slreet public Works Foe S <br /> Evaretl,NIA 98201 <br /> (425)257-0010 Guarantoo E <br /> APPLICANT NAME <br /> OWNERNAMELdCT�Y Hansen ANDADDRESS�. <br /> ANDAD�RESS:�04 B•311ef J�V�' <br /> EVERE"iT WA 98?-03 <br /> PMONE�. � 425)51�-U198 PNONE� <br /> PROJEC7ADDRESS� 1'J04 Bailey AV2 <br /> TAX PARCEL I.D.� <br /> DESCRIPTIONOF Install new catch �usin <br /> PROPOSED WJRY,: <br /> PW <br /> PERMIT CONDITIONS "� <br /> 1. All calls for inspection shall be made 2A hours in advance-phone(425)257-8810 � <br /> 2. All work shall be pertormed in accordanca wilh Ihis permil and current City of Everett Design and Conslruction <br /> Standards and Specilications. � <br /> 3. CaIlLocationUndergroundService4Phrs. betoree`���ig.@TOLL5R339�M403' Eor2a5preconstruction <br /> 4 . Call the public wnrks insp � <br /> conference prior to installing CB• ��/� <br /> 5 . Keep city st:eets clean at a11 times durinq construr_tion. w/ <br /> W <br /> O <br /> �, 0; ' <br /> � �� S -o <br /> � � �r � <br /> � �� � � � � °�' <br /> , IV <br /> � <br /> ACKIJOWLEDGEMENT OF CONDITIONS <br /> 8 �� �I Tho underrlgnad ownar/applicant huroby agroos m hold and <br /> save hermiass the Ciry ot Evorott Irom any and ull claims for <br /> D�ie damagos,cost:,expensos,or causes ol ection Ihat may oriso <br /> qpp�ovea ioi Constmcu n bewuso ol insla!IaGon and maintonanco ol Ihe in.provoment or <br /> other riyht�ol-way uso lioreto applied for and lurther agreus to <br /> removo ssme upon notice trom tha Ciry and lo replace public <br /> proporry damagod lh ob . <br /> FINAL INSPECTION �� <br /> qpprorea es Conslruc�ea Date _ <br /> Sg�awr Appicani Dale <br /> �0 COMPLETOION TH SyPERM TEMAY BE CANCELLED BYT HE CITV�UPON ANVO STOPPAGE OF WOPN ON THIS PROJEG OVER 90 D1�S IDURATIONPURSUEO <br />