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<br /> PUBLIC WORKS D810 ��1, �, ` �
<br /> JI; - '��'1 PublicWorksPermitM pW0@11- �`0?
<br /> PEAMIT ����1 '�°� -
<br /> (�1 � OulldingPermitN �f�Qp� . ,�;, ;
<br /> PU�LIC WOR�(9DEFMTMEN7 Planning Relerence a
<br /> 3200 Cedat Sfroe+l �
<br /> Evorott,WA 98201 Public Works Feo f
<br /> 1425)257-88�D• ":.� .� .: ° •'�:"
<br /> �. �, I(i :. Guerantee S
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<br /> OWNERNAME � - APPLICANTry�MF
<br /> ANDADDflE55 I�1'��T!:�:ST�'.i( f�1Vlf� �, 1 'rL�' ANOAODRESS ' � ,',���-p.
<br /> 0414 rADF kpAU ' G `{' 1 �'' " 1 , �
<br /> Eb'F.RETT qA (�'q,�'��n3 .. ..
<br /> PHONE�. Q�,ic:-jyF� PHONE�.
<br /> TAX PARCELIDN PROJECTADDRESS�
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<br /> DESCRIPTIONOf �.,`..� . I�'� P" W � F ITiSTAi.7�
<br /> PROPOS[0 WORM.
<br /> PERMIT CONDITIONS
<br /> 1. All calls lor inspection shall be made 24 hourr in advance.
<br /> 2 All work shall be perlormod in accordance with this permit and current City a �verett Design and Construction
<br /> S�andards and Specilications. �
<br /> 3. Call Lxation Underground Servico 48 hrs. beforo you dig.TOLL FREE NUMBER 1-800-424-5555 `
<br /> . �;� � . . :�i�i :. _wK.c � _i ���t^ -:t -�nd;il a .� r.n] t���� rnq, _
<br /> .�-.nn �. i >.. Ir .�. �jc•.m �{ >>t: .- � h� �tiaina���� .yat?m �;i:vii.:.; f�,�. thin i�>r. . �
<br /> . Tnat-,71 E�i�.�:i.�n ront[c�i measu[e•5 per City of Fvc[ett Stair: �ri . ���i n, i ! � :,i ,..,�1:;
<br /> � pmm�V�� nCna1n11 rOntCol mBd^urn,^, u��nq rnmpin( lnn pf [h.r ��r.�. r `i ��-�t � fl�til m
<br /> ; ( cov31 of th= pFcmit . O
<br /> . No dict, mud, e,�c4:� or dNhcia to be tcackAd onto eoadva5•.
<br /> . Pave ��C1VElV2}� iCOlfi Y.�IE• 110I1C prop�ity 11ne OU1 t0 tflr. 4t1..�'t ��.�Vlh�i. '
<br /> � . r� �:,� . ��, r.r�� .y.�rr�-T, -��� r+�.ir ra,.ri�•� r�,r,�y n.T 9_:,-3:�': .�,�r�_. �
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<br /> i ACKNOWLEDGEMENT OF CONDITIUNS
<br /> � ,� The undersignetl ewner/appGcanl heieby agrees lo hold end
<br /> �II.��/' �CC z !,�' j /5+_��,� sevo harmless Ihe Ciry ol Everett Irom any entl ell claims Inr
<br /> 4 ��' �--- damages wsls,eKpenses,oi cnuses ol ection thal mey arise
<br /> p � i�o�Cor,.a,� � - " Dvr becauso ol inslallation antl maintenenca of�he impmvemenl or
<br /> � � � / olher righbobway usa hereto appliad lor entl lurther egrees to
<br /> C,��, ���— �/� ��� romove sxme upon nolice Irom ihe City and�o replace publ�c
<br /> � ---- - - - property tlamagod�horeby.
<br /> fINAI IN. 110N /
<br /> i Appmvo 5 Conslruclrtl Dflto , . . .____ , / /
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<br /> _. _ .. I �6�gnn�olAppin:anl ale
<br /> AUTHORIZEO BV THIS PER6117 MUST AE STAR7EU WI7HIN I80 DRVS OF�AiF PERMIT IS ISSUEDAND fMEPEAFTER IS TO BE DILIGENTLV PUHSUED
<br /> MPLETION iHIS PERMIT MAY BE LANCELLED OY TNE GTV UPON ANV S70PPAGE OF WOFK ON TMIS PROJECT OVER 90 DAYS DURATION.
<br /> �� WTAB�P.INC
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