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ARKS <br />lion For <br />PUBLIC PERMIT <br />OR PRINT ONLY <br />Mt <br />Proposed Work <br />PROJECT ADDRESS (if known) <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, VIA 98201 259-8810 <br />Date <br />Public Works Permit e <br />Building Permit 0 _ <br />Public Works Fee S — <br />Chock Not B 58861 SEPA <br />cat.Date: 05/18/98 <br />Addreaet 61007 BERKSHIRE DR <br />Ownert CITY OF EVERETT <br />Tenants WESTERN WTRELESS <br />oeed Use: <br />of Work: <br />aat.nwMURICATIONS FACILITY <br />OFFICE SET _—JOB SET <br />APPROVED FOR PERNITt DATE_/_1_ By <br />Attach four (4) copies of plans for proposed work - Draw tr scale and note the follow:.ig If applicable: <br />Phone <br />Phone <br />'Properly Lines 'Outline and dimensions of all existing and proposed stn:clures on the lot "Existing and proposed utilities <br />'Centerline of street •Indicate North 'Show any proposed grading changes 'Show measurements <br />LINE <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours it advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Desir.n and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800-4<4-5555. <br />-UPLIL WORK• <br />No <br />^-r <br />MTG- <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />z <br />O <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and & a harmless <br />tha City of Everett from any and all claims for damages, costs, a ;oenses, or <br />causes of action that may arise because of installaliuri and maintenance of <br />the Improvement or other right-of-way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace public property <br />damaged thereby. <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 TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />