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PUBLIC WORKS PERMIT Date: 10/5/2009 <br /> �' Public Works Permit#: PW0910-005 <br /> City of Everett Public Works DepaAment <br /> ��;���r,�� 3200 Cedar Street Buildinq Permit #; <br /> Evereti, WA 98201 Planninp Reference #: <br /> (425�257-8810 <br /> Public Works Fee $: $ 7,'7.08 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> LBA REALTY <br /> 17901 VON KARMAN AVE. #950 <br /> IRVINE CA 92614 <br /> PHONE; 9499559397 PHONE: <br /> TAX Pf.RCEL ID# SITE ADDRESS: 2610 W. CASINO RD <br /> DESCRIPTION OF PROPOSED WORK: <br /> SITE IMPROVEMENT3 <br /> PERMIT CONDITIONS <br /> t All calls for inspec6on shall be made 24 hours in advance <br /> 2. All work shall be pertormed in accordance wilh the permit and current City of Everett Design and Construction Standards <br /> and Specifications <br /> 3 Call Loca6on Underground Service 48 hrs before you dig TOLL FREE NUMBER 811 <br /> 4 PER APPROVED PLANS c1 n1 ��� �� � V�I <br /> , w <br /> LA�I �.,�c L � 0 —���-v`� F-� <br /> �. <br /> � <br /> 0 <br /> ti <br /> � <br /> � <br /> (% <br /> 0 <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> 1 he undersigned ownedapplican�hereby agrees to hold and <br /> save harmless Ihe Cily ol Evere��Irom any and all ciaims lor <br /> damages,costs, expenses,or causes of action Ihal may arise <br /> / because ol inslailalion and maintenance ol lhe Improvemenl <br /> W� / /� ��� j;� or olher nght-ol-way use hereto applied lor and further agrees <br /> �L—t� �o remove same upon no�ice from ihe Cdy and�o replace <br /> Approved for Cons�rucUon Dat� public property damaged thereby <br /> �� ��I� /./// -Ji /% 1� �.A <br /> L INSPECTION r Date <br /> ApprovedasConsVucted �� ` �� � � SignaWreolAppllcant Date <br /> WORK AUTHJRIZED BY THIS PERPt17 MUST BE STARTFD WITIIIN I80 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY <br /> PURSUED TO COMPLPf10N. TMIS PERMIT h1AY[3C UNCF�LED BY TH[CITY UPON ANY STOPPAGE OF\YORK ON THIS PRO)ER OVER 90 DAYS DURAiION. <br />