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puB�ic woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cetlar Street <br />Everen, WA 98201 <br />(425) 257-8810 <br />IWNEiiNAME Dfi ROS)1 STEVEN <br />,NDAODRE55. 3413 FEDER7IL 1►VE <br />EVEREIT W11 98201 <br />PHONE 4253392242 PHONE: <br />TAX PAFCEL I.D. • 00437582800600 PROJECT <br />PaovosEo woaK: Ga��/GROUT STORAGE IN ROW <br />PERMIT CONDITIONS <br />Dale <br />Public Works Permit N <br />Building Permil A <br />Planning Referonce p <br />Public Works Fee $ <br />Guarantec $ <br />D8 ROS71 STEVEN <br />3413 FBDERAL 1►VE <br />IVERSTT W]► <br />4253392242 <br />3413 FEDERIIL 1►VS <br />09/17/2002 <br />PM0209-027 <br />B0209-073 <br />$0.00 <br />98201 <br />1. All calls !or 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 currenl City o( Everett Uesign and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service a8 hrs. before you dig. TOLL FHEE NUMBEH 1-800-424-5555 <br />4. Provido traffic delineators (i.e., cones, oranqa fence or device to::� <br />warn traffic) � <br />5. ]1ny da�aqe to public facilities created by this wosk �ust be � <br />repairod/replaced to the satisfaction of the City Public Worka (i� <br />inspector. <br />i -2"-0� 3.�_c,: <br />�� _G9(:�_� <br />:�U_Ti.D �7r.^_ <br />F!'�'u .SD <br />, , <br />,'i-��. _23.5� <br />� "i''�°�;.lo <br />� <br />• <br />ACKNOWLEDGEMENT OF CONDITIQNS <br />Thc undersigned ownerlapplicant hereby agrees to hold end <br />save h�vmless the Ciry of Everett irom any and all claims for <br />damages, costs, e:cpenses, or causes ol action thai may arise <br />because of installalion and maintenance o( the improvemenl or <br />other righbof-way use hereto applied lor and lurther agrees to <br />remove sarne upon rw' the City and to repWce public <br />pr dama r <br />�� Z <br />SignaWre ol Applkanl Dale <br />WORN AUTHORIZEO BY THIS PERMI7 MUST BE STARTED WITHIN 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLV PURSUED <br />TO COMPLETION. THIS PERMIT MAV BE CANCELLED BY THE CITY UPON ANY S70PPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURAiION. <br />