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OWNERNAME <br />ANDADDRESS'. <br />PMONE: <br />TA% PARCEL ID.p <br />OESCFIPTION OF <br />raoroseo �voarr <br />PUBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTI.ILNT <br />3200 Cedar Street <br />Everott. WA 98201 <br />(425)?57-8810 <br />. , � v'.i•' ., ! i �.•p, <br />I'. r L@Y•.•.�.1' I�.iV. <br />nht �: <br />. ' '<<,' :'1 <br />�:: P. 1.,�'': •�,; 1 <br />Datc <br />Public Works Permit a <br />Building Permi� # <br />Planning Rolerence A' <br />Public Works fea 5 <br />Guarantee 5 <br />APPLICANT NAME <br />AN�PDDRESS'. ;�, ,r�.,., <br />PHONE. <br />PROJECTA�ORESS: <br />� i11 <br />. .:, - ...;�Cii,�� . :i-.-�r :,n 7 , -r � --. . , ,- .. :.� hl. -�)- .�:�.' <br />PERMIT CONDITIONS <br />1. All calls lor inspeclion shall be made 24 hours in advance. <br />2. All work shall be perlormed in accordance with this permit and cunent Cily of Everett Design and Construction <br />Standards and Specilications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424•5555 <br />. . � ... .. . . . . .�, ��I i ' �. _ �� . <br />, <br />_ _ , . . ,. <br />, .. , � � , �,��_� . <br />� ��9 <br />� �` / <br />� <br />� <br />� <br />N <br />m <br />� <br />� <br />L <br />Q <br />� <br />a <br />- -- ACKNOWLEDGEMENT OF CONDITIONS <br />/� r Tha undersignetl ownedapplican� horeby agrees to holtl and <br />. �� j;i � j savo harmless Ihe City ol Everott Irom any and all daims lor <br />_� .._._ .__ __.1`C� damages, costs, expens2s, or causes ol aclion Ihal may arise� <br />�� Appro��a ior Consm�ceon U,e� � , becauso ol inslallation and mamlenance ol �he impmvemont or <br />olhm righbobway uso heroio applied lor and futlher agrees to <br />remove same upon no�ico Irom Iho Ciry and to replace public <br />- ----- --- —.. .- -� - ---... _ .. - pmpedy damaged thareby. <br />FINALINSPECTIOI� � , <br />Approved as Conshuncd Dalc . <br />.-"; . / <br />- • : /.; i �J.� - :.�_(_:>�� <br />.." ISlgnnture�ofAppticam � '-" -; .. �. � Oa(e <br />TJO CO 1P1.[�OQIN ED' SV�E�I � tE�RA� F3[ CANCELILD �Y�THETCI Y�UPON ANSSIOPPAGE OF WOPN ON THIS PPOJECT O' ER 90 DAVS IOUR TIONPURSUEO <br />onrnnnn. wc. <br />i_rvn��anoi <br />