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li <br /> �il�l� <br /> - - P�lJBLI� VI�9RK� , pub6•:Works Permn Y <br /> PER M 1 T BwMing Permfl♦ <br /> PUBLIC WONKS DEPARTMENT �lanning Relerenr.c a <br /> 3200 Codar Slrer.l <br /> Ev ,WA 98201 .f PubGc Works Fee 5 <br /> '���BqING. � o z��� <br /> ..���.1}..................�. Guara��ee E <br /> — . -____-__— _--_ _� -- _ <br /> CWNER NAME APPLILANT NAME i <br /> AND ADDRES6t Ij�"�; '� -�" �: �AND A��RESS. i <br /> . . . I <br /> _. I <br /> PHONE: � i � PHONE�. <br /> TA%PARCEL I.D./ PRQIECTADDRE55: <br /> �ESCRIPTION OF <br /> 7ROPOSEO WOfiK: <br /> PERMIT CONDITIONS <br /> 1. All calls for inspoction shall be made 24 hours in advance. <br /> 2. All work shail be penormed ir accordanco with this permtt and wrranl l'�ity of Everett Design and Construa.�n <br /> Standards and Specilications � <br /> ?. Call Location Undergrour�Service 4B hrs. belore you dig.TOLL FReE NUMBER 1-800-024-5555 <br /> . � <br /> ,�A <br /> V/ <br /> no� �si•; ;it: , neaci:i�:: upc.:: rr�,.•. ? . n .:.2 tr u :i•:t ; : i i i.•: i W <br /> ..31 f thF � ¢it . � , , � <br /> .1 aX�731'3?BO iG3C�_!'13i fC�'•�. IOU!1�j3C1�_tl, 91C19'.�'3aF' 311�1 .��C:':�w .j+1.s,9IlSiL' i:,d , . O <br /> �.r��v :f� �:.:rro. tre<i ;,?tr�. No w�sr�m:a ot roat�>nt�] ia allo•..•�9� im ri�i��' l���i�j �, . ' <br /> dii! , rz�.i�i, r�. -�,.� ,..� drh• i- tc t," trarka�t nRrn Cn3�U.y.�, <br /> . ' . . ' . . . _. . . �.E : ..:'I'f.._t .pc.. .r.:t :.t . t.a. }. � <br /> � <br /> � <br /> � <br /> � <br /> a <br /> ��. ACKNOWLEDGEMENT OF CONDITIONS <br /> // Tho undersignatl owner/appllcant hereb; eg�.�ea to h-.d and <br /> . � `,��� /.�� // /;�//�/ save harmless ihe Ciry ol Everetl from a�y��ntl all alainis lor <br /> �it+' �� �'� <<' dameges.cosis.ezpenses ✓c,uaes nf au:a��hat may anse <br /> M(fpmvo lor Conslruction Uale <br /> ,.Q /] . �/ � ba��=usn ol instxnauon and maintonanco ol Ihe i�nproveme�'or <br /> �j' / ,i� � other nghbobway use harelu applied ior an01„Aher agrecs tn <br /> �� ` f� Z v � remove same upon nol�ce Irom ihe City a.�d Io replace puhhc <br /> ' IINRIINSP�N <br /> � —�-� pmpertydamagetl � � <br /> �. Appmved es CanStructo0 Cata .-, <br /> � � // ���.�2 <br /> � ..__. . _ ._._.. .___-_ . ... __ _. ___.__.___.. —_ Signnlurno;Ap9K t �ate <br /> ��_ <br /> ;7��HN AUTHOPIZ[D BV iHIS VENMIL MUS'!BE SIARTEO'.YIIHIN 1rJ OAV 3 Ot DATE PEHMIT IS ISSUEDAKD THERLAI '. R IS TO BE DIGtiEFlli/PURSUE� <br /> n��'.pMPLETION 'MIS PERMIT MAY BE CANCELLED BY THE G1V UPON�NV STOPPAGE OP WORK GN TNI3 PFOJE�T OVEH 90 DAVS DURATION <br /> i� ..� �.� <br /> nnaFi+n wi <br />