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� PUB�ic woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Streel <br />Everen, WA 98201 <br />(425) 257•88f 0 <br />OWNERNAME GOURLIE GWEN <br />ANDADDRESS: <br />601 COLBY 11VE <br />EVERETT W11 982 <br />PHONE: <br />TA%PARCELI.D.M 4y <br />DESCRIPTION OF <br />PHOPOSED WORK: <br />� <br />PERMIT CONDITIONS <br />APPLICANT NAME <br />ANDADDRESS: <br />PHONE: <br />Date <br />Publit Works Pertnit M <br />Building Permfl N <br />Planning Relerence N <br />Public Works Fee S <br />Guarantee E <br />/ <br />03/30/2000 <br />PW0003-067 <br />B0003-040 <br />$ 25.00 <br />10012 4TH AVE W �2 <br />EVERETT W11 9820 <br />(425)422-9990 <br />601 COLBY AVE <br />i. A�I calls for inspection shall be made 24 hours in advance - phone (42F) 257•BB10 <br />2. Atl work shall be pertormed in accordance with this permit and current �ity of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dir�. TOLL FREE NUMBER 1-800-424-5555 <br />����D <br />� APR 1� 2000 <br />CiT`I �F gB�Eces'C'f <br />pe�m <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />- <br />f� <br />m <br />O <br />� <br />Z <br />O <br />� <br />a <br />�I he undersigned owner/applicanl hereby agrees to holtl and <br />save harmless the Ciy of Everett from any and all claims lor <br />damages, costs, ezpenses, or causes of adion that may arise <br />because of installation and maintenance ol the improvement or <br />other ri h4of-way use hereto applied for and fuAher agrees b <br />re� same n notice Irom the City a�repWce public <br />pr d e t r <br />�� r� �yi ev <br />SignaWre ol Applkant Date <br />WORK AUTNORIZED BY THIS PERMIT MUST BE STARTED WITHIN 100 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLV PURSUED <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CIiY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAVS DURATION. <br />