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PUBLI�: �IIORKS - ` i� '';�'' <br /> , , . <br /> PERMIT PublicWorkSPermi�N Ey�,;�,1_���Q <br /> Building Pe�mit a <br /> PLIBLIC WOAKS DEPARiMENT Planning Rolerence# <br /> 3200 Cedar Streel <br /> Evorett.WA 98201 P�blic Works Fee E ��, 111.::? <br /> (425�257�8810 <br /> Guaramee E <br /> OWNE(i N�ME APPLICANT N�M[ <br /> ANDAD 5 '. _ �__ ANC/ADDRFSS ��� FA )�' <br /> � � /., 1-„ Jr . ,���� °^ �-' 12�� ' 7H s; Ni; <br /> E1 �� iA �8:�i!, <br /> a�ioNr. ���,' .�'�' ,:.� - /= - / rHONe 4:5508265[ <br /> lA%PARC[I.IDM PROJ[C1ADUf1[SS5",� `. �•��I�.' <br /> oescnirnoN or H�:q �FT. �"�'MPLE>: <br /> rnorosr_o woi+k <br /> PERMIT CONDITIONS <br /> 1. All calis lor inspecUon shall be made 24 hours in advanco -phone (425) 257-BB10 <br /> 2. All work shall be performed in accordance wilh Ihis permit and cwren�Ci�y ol F_verelt Desi�n and Construr,lion <br /> Standards and Specilications. <br /> 3. Call Location Underground Service 48 hrs.before you dig. TOLL FREE NUMBER 1-800•424-5555 <br /> �i. PEF. lfti��VEG FI,AY> i,t.7'f:l"• : 1- -!i� L� <br /> '�^ <br /> .. V/ <br /> � _ � _. _ ,. � <br /> , � .' ,t.:� '� - O <br /> ::. � <br /> .. _ Z <br /> :. .. �. O <br /> , ..� - <br /> �ry i - ,r. � <br /> . .. . '.... .. O <br /> � a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ' �" '� The undarsigned owne��applicant hereby ag�aes to hold and <br /> � ' save ha�mless�he City ol Evmett irom any and all claims lor <br /> �-��-;=�G <br /> ''T�ry,�o���Cunsuucu n bme dmm�ges,cos�s.erpenses,or causos ol acUon Ihat may erise <br /> because ol installalion and rtiaintenanco ol�ha improvemen�or <br /> other right�ol�way use here�o applied lur and lurther agrees to <br /> remove s�me upon noUce imm�he Gity and to replace puWic <br /> FlNAL INSPECiION properly damaqad Ihereby. <br /> Appmvod as ConslructeA f1alN :- � � <br /> .r...�_!-.____1_.____—____�. �.�!.. �._ .....__. <br /> SignzWre ol Appli�qnl Date <br /> i. <br /> WORK AUIRUHIIf U Bv 11115 PlP�hdll IAU�i flC S7�Rff0 WITIIIN 180 DAYS OF D�1F P6RMIT IS ISSUED AN�THEREAF7ER IS TO BE DILI6ENTLY PUflSl1ED <br /> TO CORIPLL7ION lIIIS Pf.R1.71i IdAv[1L CAflCfl LCD f7Y iHf.CITV UPON ANV STOPPAGE OF WORN ON THIS PROJECT OVER 90 DAYS�UFATION <br />