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A I <br />lto�/4 <br />PUBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />Date <br />Public Works Permit # <br />Building Permit # <br />Planning Reference # <br />Public Works Fee $ <br />Guarantee $ <br />OWNER NAME AND ADDRESS: <br />AND ADDRESS: PUGET SOUND ENFR;'. <br />3130 S 38_rl ST <br />TAC(-ANA lip. 9840_ <br />PHONE: ( 7.7F"- 11 PHONE: <br />TAX PARCEL I.D.# PROJECTADDRESS. T <br />DESCRIPTION OF T1ISTALL ANODE }sBD WITB SQIs1P, STATT�1: POLE <br />PROPOSED WORK: <br />.. -.+ SFth $t a 'ic r r'/_ 1.-n _'`• - r„i PW corner of <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hours in advance. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />4. Post fir solar Station to 1,e located next to the chair link fence on the east tide <br />- eraing St <br />S. Provide traffic control per the 14UTrD and as directoed by the Public Works <br />'nspert�r O=Jiff, 425-339-T404) <br />_J <br />W <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless the City of Everett from any and all claims for <br />damages, costs, expenses, or causes of action that may arise <br />because of installation and maintenance of the improvement or <br />other right-of-way use hereto applied for and further agrees to <br />remove same upon no Irom the City and to replace public <br />pro <br />pe <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED <br />TO COMPLETION. THIS PERMIT MAYBE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />DATABAR. INC. <br />EPWP (7/06) <br />t /In <br />