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� <br />PUBL�C WO�'KS <br />PE�MIT <br />PUBLIC VJORKS DGPARTIdENT <br />3?�0 Ceder Street <br />Everett, WA 98.'.01 <br />(425) 257-8870 <br />7 S� i3�`$ � <br />OWNERNAME <br />ANDADDRESS: .. . i' '!f•:T.:1Yx i�'.�`: <br />?:. r..'.: �.i; <br />- cr.,, �•r <br />PHONE: <br />TAX PARCEL I.D.q <br />DCSCRIPT10tJ OF <br />PROPOSED WORK: <br />w1, . _ � � r. <br />Date <br />Public Works Pertnil k <br />Building Permit p <br />Planning Relerer:e k <br />Public Works Peo S <br />Guaramee S <br />AFPLICANT NAIdE <br />ANDADDRESS �•' � �� � <br />PHONE: - _ � .. _ <br />IPROJECTAGDRESS:.. _ <br />�t(1.14?'Iq�li)�}F.yq�, .n� i, i � <br />_ -1ra�. F:•n f��sfgr•,,,'. �_.x.�, "„c,..,.�-•r�a•i� <br />��I:,L�Z11�� F: Y=.Lx I• �H ..: ln. r� l i ;,ry i- __ �. <br />PERASIT CONDITIONS <br />1. All calls tor inspection shall be made 24 hours in advance. <br />2. All work shall be pedormed in accordance with lhis permit and current City of Everett Design and ConsWclion <br />Standards and Specilications. <br />3. Call Localion Underground Service 48 �vs. b�;ore you dig. TOLL FREE NUMBER 1-800-424-5555 <br />�.,:��.�_ . . ., ....� ._.. ., .. � ,u::�. �..t.., ::r.•�.�.. <br />. ... _ .. .. ..__. .. , . .-i ..tt ,It . .,. <br />.!` f'_ <br />.t-,.,. ,,:, ,_:,- _ <br />� <br />,��u,� � <br />�jJyZ �� � <br />. '`� J ' . 1+�/�l J <br />.^f %J`''.,. `�.j � . , . <br />,�:�_. <br />P�,L�, o�� <br />��� <br />����� <br />� <br />�_a�-��7 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />r�- �� • Tho undersigned ownor/applicant hmeby agrees to hold and <br />�� t��l /;� /.. ��v.';,.� 7' save harmless tho Cily of Eveietl lrom any and all claims for <br />�'� r" � damages, cosls, expenses, or causes ol action that may arise <br />ro�4p Ior Constructlon Oa�e because ol installation and maintanance ol the improvement or <br />/ � <br />othor nghl-of-way use herero applied lor and IuAher agrees Io <br />..--� , ,� � remove samo upon notice irom the Cily and to replace public <br />FlNAL iNs CrioN property damagetl Ihereby. . <br />Approve s Construqetl alu . <br />� / - <br />� . — _ <br />Signature Appiitanl . --- _ _De�o <br />WORK A11h10R12ED DY THIS PEPMIT MUST BE STARTFD WITHIN 180 DAVS OF DAT[ PERIdIT IS ISSUED AND THEREFFfER IS TO OE DIUGENTLY PURSUEO <br />TO COMPLETI01d. THIS P[RMIT IdAV DE CANC�LED BY THG CITV UPON ANV STOPPAGE OF \NORK ON 7HIS PROJECT OVER 90 DAYS DURATION. <br />�rwn � nec, " onrnena. iHc <br />a <br />WL <br />r <br />Y/ <br />W <br />O <br />Z <br />O <br />V/ <br />0 <br />a <br />