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C <br />Date: <br />'et� `.: : l�UBLlC WORKS PERMIT public Works Permit#: <br />��,,. . <br />' � City of Everett �g,,blic Works D��r�(�OC1HU) 10:13 guilding Pemlit #; <br />,�,;.,�� ' 3zoq��{iar street �EGl 028'�80 <br />. Everett, V11A 98201 , CT P]anning Reference #: <br />. (a���7�s�gppb public Works Fee $: <br />1 OTHER �186.00 Other $: <br />OWNER NAME AND ADDRESS: ��iECK <br />SNOHOMISH CO. PROP MGMT <br />3000ROCKEFELLER AVE <br />EVERETT WA 98z01 <br />PHONE: 4253883400 <br />AX PARCEL ID # <br />DESCRIPTION UF PROPOSED WORK: <br />BRT STATION-(2807, 2810, 2783, 2784) <br />NAME AND ADDRESS: <br />7100 HARDESON RD. <br />EVERETf WA <br />PHONE: 4253563435 <br />SITE ADDRESS: MULTIPLE <br />98203 <br />: : �.� <br />J� ��- � . <br />$ 180.00 �- <br />(8/18/2010 11:22 AM BES) <br />STATION#2i07(6729 EVERGREEN WAY), #2810(6210 EVERGREEN WAY), #2783(11131 EVERGREEN WAY), <br />#2784(11202 EVERGREEN WAY) <br />PERMIT CONDITIONS <br />1. Ail calls for inspection shall ba made 24 hours in advance. <br />2. All work shail be performed in accordance with the permit and current City of Everett Design and Construction Standards <br />and Specifications. � <br />3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br />4. CONSTRUCT PER APPROVED PLAN. <br />. <br />for <br />FINAL INSPECTION Date <br />Anoroved as Constructed <br />W <br />H <br />F�I <br />� <br />� <br />� <br />h <br />z <br />0 <br />H <br />� <br />0 <br />a <br />ACKNOWLEDGEMEN'f OF CONDITIONS <br />The underslgned owner/applicant hereby agrees to hold and <br />save harmless the City of Evereri from any and all claims for <br />damages, costs, expenses, or causes of aclion thet may arisa <br />because of installation and maintenance ofthe improvement <br />or other right-of-way use hereto applied for and further agrees <br />to remove me upon notice ftom ihe Ciry and lo replace <br />ubli pr pe ydamagedthereby. <br />, <br />Signature of Applicant <br />Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE SfARTED WITHIN iB0 DAYS OF DATE PERMIT IS ISSUED AND THERFJIFTER IS TO BE DIISGENTLY <br />_...... �.......� -.........-..........�.vui..:_ _'.�...cnnm� n�2oannnVGN <br />