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/ <br /> P����� ����� Date ;;�� � 7 ;�n�ib <br /> ������ Public Works Permii R yG.,�b��-_���� <br /> BuildingPermilN EODJG-0.:�} <br /> PUBLIC WORYS DEPARTMENT Planning Reference# <br /> 3200 Cedar Sireet <br /> Everetl.WA 38201 Public Works Fee 5 �y �,:,� 3` <br /> (425)257-8810 <br /> Guarenlee S <br /> OYJNEHNAM�H� pU'�F.: ST�:FiES I}iC APPLICANTNAME <br /> ANDADDRE ANDADDRESS: <br /> =001 SE 11iTid �T DEPT ci8f <br /> rr .�r�nT��C Q�'T 24 2006 <br /> Bentonville hR 7�T:ri <br /> PHONE: PHONE'. <br /> TAX PARCEL LD.q. PROJECT ADDFESS: <br /> t�C99�91iC4i�2p0 ll�,i0 &VEF:�RF.E1J 4i?.Y <br /> DESCRIPTION OF VELI FF.1iDA FX P:'S.`i.`i <br /> PROPOSED WORM <br /> PERMITCONDITIONS L`�r- � "= B�u �=-����r� <br /> 1. All calls for inspection shall be made 24 hours in advance -phone (425) 257-8810 <br /> 2. All work shall be performed in accordance with this permit and c�rrent City ot Everett Design and Construc�ion <br /> Standards and Specitications. <br /> 3. Call Location Underground Service 48 hrs.before you dig. TOLL FREE NUMBER 1-800-424-5555 <br /> W <br /> -. ?4.i jBL 3;ij'•�.JVt,•i. �>13❑ :jd'r_:� �.�j;'..�'1t� 3iU: Lfl� 7Uf)11C whiLEC:: ili:j>Pt,�JC�9 �j1CN�7tipll lA � <br /> .he iiaid. �I� <br /> -n'i� n' c'n�9-� rI■ <br /> �-� F-F-� t--F-• F-- H F-•r F--r � M \I/ <br /> 'A� <br /> C7r�-s'�C'-�.��',.'_o�����m�`�� �z � m <br /> � � czncc`"' � �e� � o O <br /> c=� Q <br /> c � � <br /> {f� i� r�c.�T� <br /> L! `J� Z <br /> . � O <br /> • 1 � <br /> tn � ur � <br /> i�i T r �u�r s��r,�+� ,�-�' � <br /> ..��-`r'rrv'-�-.w�r.J�r .arno -� d <br /> -j� -.]CA�O `*t��*IOU�F-��t�. WF- <br /> : L1(_•1_C,`t]�I?�4^,1�`nOr�, JOOpL�Op�L��i• O � <br /> GO��-`-�(J�m�jLim�1--GNGOOG>1 C�� <br /> tiG H O <br /> r� � <br /> ACKNOWLEDGEMENT OF COivDITIONS <br /> ��C/ �� /2/� The undersigned ownerlapplicant he•eby agrees to hold and <br /> "('/ save harmless ihe City of Everett from any and all claims for <br /> Approvetl lor Conslmcti D��e damages,costs,expenses,or causes of action ihat may arise <br /> because of installation and mdiNenance of ihe improvement or <br /> ��,��� other righFof-way use hereto applied for and lurther agrees to <br /> ��_ remove same upon notice Irom the City and to replace public <br /> f� f AL INSPECTI N " properry damaged thereby. <br /> Appmvetl as Conslructed Daie I <br /> /O -O v -�v�-��� r /o ob <br /> S � � Signalure ol Applicant �� Da�e i <br /> V/GRK AUtHORIZ[D�Y 7HIS PEHMIT MUST BE S7ARTED WITHIN 180�AYS OF DATE PERMIT IS ISSUEG AND THEREAFTER IS TO BE DILIGENTLY PURSUED I <br /> l O COMPLE710N.THIS PERh11T MAV�E CANCELLED BY THE CI7Y UPON ANV STUPPAGE OF WORK ON THIS PROJECT OVER 90�AYS DURATION. <br />