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\i!� PUBLIC WORKS ��� Date ��Z `— L�d / <br /> U� � � PubliC 1Norks Pcrmit a ���0,�;p� <br /> a q�- ; <br /> ` ',�(YC PERMIT ��� `\�, ,:��. pwldingPerm�lu ,) �� <br /> � N <br /> ' PUBLIC VlORKS DEPARTMENT �.���.� :\r�, Plannmg Referencc d � <br /> 3200 Cetlar Strect ' ��� � � <br /> Evcretl,WA 98201 � Pu61�c Works Fee S <br /> (425)257�8810 <br /> �ll� GZ� �� �Q � ��e/'�' n e5 <br /> OV/NERNAIdE G-ASC�D� VIFW NG14H�[►' APPLICANTHFIdE c� IN� W,� 1^ �� <br /> AIJD nODRESS aND nD�RE55�. � <br /> R3e� 3�� P� s�.J <br /> E�,� <br /> PlIONE PHO�+E ���/ ���D� �D�I �' <br /> �S(!j- AJoV�G <br /> 7A%PARCEL i D a P�70JECT AODRESS: /D�� g l�� �✓`r �M � � <br /> ( <br /> f1fSCRiPiION O� 'yK g ,�11 �„��.1�j0�'N�� 5 �9✓� �✓� / w J <br /> PROPOSED WOPh � � <br /> PERMIT CONDITIONS <br /> t. AI!calls lor inspechon shall be made 24 hours in advance - phone •;A25)257-BA10 <br /> 2. All work shali be performed in accordance wilh Ihis permit and currem Ciry ol [verett Design and Construcfion <br /> Standards and SpeciGcaiions. <br /> 3. Call Locat�on Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br /> `(. Wlo lle 5�i� ��� P���f o � �uz si n are �-� ,e�g�- 2� �4��% -l�o.,� �' <br /> � �aLV l71� SIL��l4k'� . ��d �Q Sl�/2 � Sl�jl'� ypQS�s L�Ir� �� r� <br /> I <br /> � � � s;� �G�� r. <br /> I Q�s� 3 ���r, �«w. 1��. � ,.K, m <br /> s• ►�ov..��,�� f�os�s s����� �� yky �o� . � O <br /> �.� T� S�ti(I �-� � 1� �4 �,�-, s��� � 4-I-4-G�(�m? �.�.�.,��,. z <br /> � O�� . . ( fO.�� �J✓� r 1,.� ��� I(O .Q-lF..� BW'��.✓� V O <br /> ���.�, �.��P�s�� i- � � !� P � H/A <br /> 7 A G O Hqv,�p ro��s�'� V! <br /> O^ <br /> L.i. <br /> ACKNOWLEDGEMENT OF NDITIONS <br /> The undersi9ned ownerfapphca ereby agrees to hold and <br /> �. 3 •2 H���I savc harmless lhe Gry ol Ev �t Irom any and all elaims lor <br /> rup v2d lOr Conslruclion Date damages, cost,,expmse�,or causes ol aclion Ihat may aiise <br /> because of installation d mainlenance ol Ihe impmvement or <br /> 1 ` 1I�1n_ olher righbol�way u hacro apphed lor and IuNier agrees to <br /> ;vo��' 1�}'�Vi remove same u � notice Irom the City and to replace public <br /> FINAI INSPECTIO proDerty dam etl theieby <br /> Appiovetl as Consimaed Oale <br /> S�goa �e ol npn��wm � � oate <br /> WORK�UTHOR2ED BY THIS PEfiMIT�l1UST OE ST.RTED WITHIN IBO DAVS OF DATE PEfi1dIT IS ISSUED AND TMEREaFTER 1510 BE DIUGEMLY PURSU[D <br /> TO C07dPLETION.THIS P[Rh11T PAAY�E CANCELLED BV THG CI7Y UPON AIJY STOPPAGF OF WO'7K ON iH15 PROJECT OVER 90 OAYS OURATION. <br />