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:. <br />��� <br />��� <br />OWNERNAME <br />ANDADDRESS: <br />�us�ic woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Strect <br />Everetl. WA 98201 <br />(425) 257•8810 <br />PHONE: <br />TAX PAR(:EL I.D.N <br />DESCRIP710N OF _ _ <br />PROPOSEDWORK: � - ��� � <br />PERMIT CONDITIONS <br />� <br />r,�,; <br />Public lNorks Pettnit K <br />Buitding Permit a <br />Planning Relerenca !! <br />Public Works Fee S <br />Guarantee 5 <br />PHONE: � " �� <br />PR0.IECTADORESS: . <br />1. All calls (or inspection shall be made 24 hows in advance. <br />2. All work shall be per(ormed in accordan^e wdh Ihis permil and cunenl City of Everetl Design and Conslruc:ion <br />Standards and Speci(ications. <br />3. Call Location Underground Service 48 hrs. belore you dig. TOI..L FREE NUMBEH 1-800-424-5555 <br />� > i' .. 7�".a <br />��}��<� �.. _ �� f�,y �.,��� .� .��� - � - <br />:, t � � „ : r , �,, <br />.s . <br />'"i t,�...�'.�: � ,. .. <br />tir���3 .�... ± " <br />� +3 ' k � <br />�:�: <br />� <br />� - .,o . .. i . . � r,�. <br />ACKNOWLEDGEMENT OF CONDITIONS <br />� � The undersigned owneriapplicant hereby agrees to hold and <br />-- �,/��� /�/8 � j save harmle;s the City of Everett Irom any antl all claims lor <br />l{ � �- damages, costs, oxpenses, or causes ol action ihat may arise <br />.o�oved or Construction Date because of installalion and maintenan.e ol Ihe improvr.ment or <br />�c��/Q �li p. olher right•oi•way use hereto applietl for and lunher agrees to <br />���- ( 2 1 remove same upon noti;,e irom Ihe City and to replace public <br />�-- iL��✓'_. <br />FItJAL INSP 'ION pr �y damaged �her by <br />Approve0 nslruqeE Date <br />S�gnalure A� nt �. <br />WORK AUTHOf71ZE0 BYhIIS PERMIT MUST BE STARTED WI7HIN 1BO DAVS OF DATE fERMIT IS ISSUEDAND THEREAFfER IS TO BE DIUGENTLY PURSUED <br />TO COIdPLGTION. THIS PERMIT MAV BE CANCELL[D 6V THE CITV UPON ANV STOPPAGE OF WO�K ON iHIS PROJECT OVER 90 DAYS DURATION. <br />I. PWP G-041 DATABAR. ING. <br />W` <br />r <br />N <br />m <br />0 <br />z <br />0 <br />�/ <br />O <br />a <br />