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PUBLIC WORKS Da�e <br /> Public Works Permit k . <br /> PER M 1 T puilding Permil# <br /> PUBLIC WORKS DEPARTMENT Planning Pelerenco# <br /> 3200 Cedai Street <br /> Everett,WA 98201 Public Works Fee S � <br /> (425)257-8810 � . <br /> Guarantee S <br /> OWNER NAME APPLICAN7 NAME <br /> ANDAOORESS: � - -- - . -,- - ANDADDRESS: - - �� - , , � - ;u--. ,�,+, <br /> PHONE: � PHONE: . . . <br /> TAX PARCEL I.D.N PR0.IECTADDRESS; <br /> DESCRIPTION OF <br /> PROPOSED WORK . . . . . . _. . - . �� � . _ . ...- . _ .. <br /> � , <br /> � '/: L��'.'� <br /> PERMITCONDITIONS � !i��� "'ii: � <br /> 1. All calls lor inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with lhis permit and current City o1 Everett Design and Construction <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-024-5555 W <br /> __ <br /> � <br /> � <br /> ..�_ .. . ..;}yli�l' �� W: i.'�:�UiC�' �� llli:L1I'. 11 ��: . _ Jr-�iL . i I..1.:11.' •�C .. . . � . . . . � <br /> �ck nsy inrli:rl� a ,,nN-7ane rl.,,sura alnng th� e�s' szdF nf Glenhav:rnl� � <br /> :nr r, cna slide zr?a ar 47q�; Ulenha�t?n Dcive. Ttie ap�l:rant mu3t rc<- O <br /> -� tcafizc :�+r.tLoL I'Tc�V_c't2 fligc�eCs �ahzn 3lenhs�v�n Diivu __ ]imited . <br /> � ,7�iY_]I14 one-uay CC;iffl�`. 'M.VG��j �?���r�+d�7t:9 llUCt71�7 �Jcnl: lIOHCS. ' <br /> he spp]i�:•;nt may makrr ]imitec' u:::- nf the puh]ir Rlrfht «f t°:,y (F!�) ainm� r <br /> - Si�jc p° MU�.^_LtBn �:J�119VaC'� ICC C�l� j?UL'�iCS?5 qf IIdt�_'la� I13R�'�1[:�J. NO GtC�C� � ... -.. � <br /> . Of Jh2i8Cld1 It�9�. bB �torkpilE'•:I Ii!t tY-8119F���CC ifi 9OV i11Re i�UL1f1<I t11< U��C3'. . • O <br /> itFC1�31 F1dI1��11.11�7 dC�3 ?Y.ta�7rii �C:'�1� C�1F P},'T'PI1�P�� p1��7�'1'iC•(lt t'C1V? �.'�'17ta_Clit�,- . <br /> ; i�nate?y 20n', nIong the� sourh si,9F. Flukilteo RoulFvard R:W. � <br /> -_COVl�j'�- 3I1�'� iR9�glj Sijt, fatl'"- �}aC Cit}' Stil1�13C�� F`1�9[i �/;], GQSp tp r�u•�an' . . <br /> ii��m es�apin:� the mateL�,l han•:il�na sre,. N <br /> taVr?Ilt [L'dC�:lh�7 ��f. RiU��r ^1J.0 n[' qi�1�3C ��'�?C19 OIl t�:� tjl� ['n.3tlWd�f �C dll tltr�. � O <br /> I�reparHd tr� pcnvlcle flagr�ui�v ii con�iiti,:ms w:irrant . <br /> -�•.':�OlC( 1ILF�•atl't14 CCd:Il•. 31CI1:: 1•i:llill.tun E'.nLLl?V3L'�j. Ni�]�ll��n �?U��3V3C�� I6U9L :�. ' . � <br /> . ._�,;7 dY iilV CiWe.. HVClS] li�3i�lTlt7 and hau?-aut �p�_-,iion� from !+3!!i CO C�3!f� Eit'�' ' � <br /> .� FJ'9� O❑ W:�{CQ3}'ii. <br /> ,�tn..� r,;gtnct,:-d .ar��at rerev: an}� �r,^umvliieil �iZt nx 49-rt <br /> ___ _ . .r ; .e =- -_ = z�:c.er.- _. . . <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � . The undersigned ownedapplicant hereby agrees ro holtl and <br /> •. �� sava harmless Ihe Ciry of Everoit Imm any and all claims lor <br /> "�� damages,costs,ezpenses,or causes ol action Ihat may arise <br /> npprov o Consvuclion ' �am because of installation and maintenance of the improvement or <br /> .i ' / othar right-ol-way usa hereto a.pplied for and further agrees to <br /> . ,.� � �(0 0 romove same upon nolico irom the Ciry and to replace public <br /> FINAL INSPE ON pfop damaged ihe�[�yby • \ <br /> Approvetlns onstruclotl Deta �L,�Q , ; �` �/ ` /� ,- 1 � -�, -��] <br /> rtCarr u� ( <br /> - � _ - — --- -- <br /> SignalureolApplict(n� De�o <br /> WORK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHIN 1B0 DAVS OF DATE PERMIT IS ISSUEDAND THEREAFfER IS TO BE DILIGENTLY PURSUED <br /> TO COMPLETION.THIS PERMIT MAY BE CANCELLE�8V THE CITY UPON ANY STOPPAGE OF WORK ON TMIS PR0.IECT OVER 90 CAYS DURATION. <br /> LP�VP 1]AGI OATAOAR.INC. <br />