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1 <br /> PUBLlC WORKS De�e <br /> PuWic Works Permil0 � . . � <br /> PER M IT Bullding Perrtit N <br /> PUBLIC 1A'ORKS OEPARTMCNT Planning Ralerence N <br /> 3200 Codar Slreot <br /> Evero�t,WA 98201 public Works Feo f <br /> (425)25)-8810 � <br /> Guerenlee S <br /> OWNER NAME APPLICANT NAMC <br /> ANDADDRESS�. �� ' - �� '� � -� " � � -- � � - ANDADDAE33: - <br /> -" �- . ,_ rn O�C ^ n <br /> ... . . . - . , � , �. Zl� <br /> ` 1 <br /> . . .. ..-.. .: ._'7:)_ . ,. u, I �.i !�V�il �l�t'.... ..........!'.......... .... <br /> PHONE: . � � . PMONE: <br /> ' � . <br /> T�%PARCEL LD.♦ PR0.IECTAOORE39: <br /> .� . - - +. � -' <br /> DESCRIP" 'ON OF .. . .. <br /> PROPOSEO WORK: �� <br /> P[RMITCONDITIONS ,C'.';E=' " . . <br /> 1. All cal�s lor inspection shall be mnde 24 hours In advance. <br /> 2. All wa�k shatl be porlormed in accordance with this permit and current Ciry ol Everett Design and Construcllon <br /> Stendards and Specllicalions. � <br /> 3. Call Locetion Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1�800-424•5555 ` <br /> r <br /> _ , �w <br /> _ . � • . . . . _ . ..... . . V/ <br /> . . � .. .i�. . ,, �. , ;� � , ._�!t;t ni . :,; � � � . , .. , . � � . W <br /> .`a]] �i��.-,nic�n r•cmti� l meHsu�e �,rr �^�ty of Ev!-i �tt ;tardaecV- fc�r small � . <br /> ._.mnya ntp�1C❑ �C�i17�C�.•1 [G�?3�UC�.', u�cn coaE,lerion Cf i�1@ pc�>jn�J* �]tl�?C CO � - . O <br /> val of th� peec.it . <br /> . . , .��.aw�ta�l mateci:+l f�<,m fr�i.�nd�+tion, siduv�.ik and dnvNvnys vir, � - � .. .. . ' <br /> :��d, �„emitt�•d �ite. 110 vaating of mat�rrial i� ,vllnw±d n❑ ri , � <br /> :et, r.ud, crck� oe detrir to t�e ttncked c �.:i, -, . <br /> dciv�•,�ay Crom th> fcnnt pro�,eeCy lin? O <br /> - � <br /> N <br /> O <br /> a <br /> - - -- ACKNOWLEDGEMENT OF CONDITIONS <br /> ` The undorsigned owner/applkanl hereby agroes lo hoid entl <br /> � . /�., / �� p � save hermless Ihe City ot Everelt Irom any and all clai�s br <br /> dl' a1�:�_ / damages,wsts,eKpenses,or causas o1 action Ihat ma anse <br /> Ap � d. onslrucl�on ' D bocause ol instellatbn and mainlenance ol the Improvement or <br /> �i • n o�her right-ol•way use hereto applied lor end IuAher agrees to <br /> �,C� �Gh� '4 -Q' / remove me upon notke the City and lo reptece public <br /> -��-�-� — -- pro demaged Ihere . <br /> FINAL INSPECT N � <br /> A�prweA es Constmctetl Oate /��! /./ <br /> •• �� V��� <br /> ___ ______ __ Signalu iCen1 Dele � <br /> WOHN AUTHORIZED Bv TI'i5 P[RMIT MUST BE STARiEG WITHIN 1&7 DAVS OF DATE PERMIT IS ISSUEOAND TNEREAFfER IS 10 BE DILIOENTLV PURSUED <br /> TO COMPLETION THIS PC4MIT MAV BE CANCE�LED OV TME CI�V UPON ANV STOPPAGE OF WORN ON THIS PPQIFCT OVEN BO DAVS OUfiATION. <br /> lPWf'1��1 DATABAR.ING. <br /> � <br />