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PUB��c woRKs
<br />PERMIT
<br />PUBLIC WORKS DEPARTMENT
<br />3200 Cedar Street
<br />E�425,'25� 88,�0 P`)ST�NG �aN o s
<br />OWNERNAME yfj(pLE� BF��:iF.!1
<br />ANDADDRESS: ",
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<br />PHONE: �i; 5[•qh::J-�$
<br />TA%PARCELI.D.p �)�I7�j�it(l�1tIJi1111
<br />DESCRIPTIONOF ��F.N I�l�l'I�E�'
<br />PROPOSED WORK:
<br />4b.,a.�
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<br />PHONE:
<br />Date
<br />;'1 �_�•F+;�riUd
<br />PublicWorksPemAN FF1ii��tfF-01�1
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<br />Buiiding Permit A
<br />Planning Reference #
<br />PublicWorksFeeS ;,�.,��n
<br />Guarantee $
<br />PROJECTADDRE55: r,jf��:; Fi�G'P41?hi F'U
<br />PERMIT CONDITIONS �=` �� �=��"��� � E:fAF3I,'i !tl l,i.:7 bi `: •7
<br />i. All calls for inspection shall be made 24 hcurs in advance - phone (425) 257•8810
<br />2. All work shail be per(ormed in accordance with this permit and current City of Everett Design and Consiruction
<br />Slandards and Specifications.
<br />3. Call Location Underground Service 48 hrs. before you dig TOLL FHEE NUMBER 1 800-424•5555 �.. �
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<br />� ACKNOWL�bGEMENT°OF, �CONDITIONS
<br />,i:. ,.
<br />lor Consiruclion
<br />FINAL INSPECTION
<br />Appmved as Censimcted Dalo
<br />The undersigned ownedapplicant hereby agre�s to?�old 'an��':: `��
<br />save harmless the Ciry of Everettbap.aOY and all claims for
<br />damages, costs, ezpenses, or causes of action that may arise
<br />because of installation and maintenance of the improvement or
<br />other right-of-way use herelo applied for and fuMer agrees to
<br />remove same upon notice from the City and to replace public
<br />property damaged thereby.
<br />;j,� .�y 1,� i �;?i...Ll
<br />�
<br />� � Signalure ol Applicant Dale
<br />WORK AUTHORIZED BY THIS PEHMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE OILIGENttY PURSUED /
<br />TO COMPLETION. THIS PERMIT MAY �E CANCELLED BY TH[ CIN UPON ANY STOPPA6E OF WORK ON hilS PROJECT OVER 90 DAYS DURATION.
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