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PUBLIC WORKS Date <br /> Public Works Permit a � � <br /> PERMIT � ' <br /> Building Permillf ��.���:� <br /> PUBUC WORKS DEPARTMENT : Plannin9 Relerence N <br /> 3200 Cedar Street <br /> Everett,WA 98201 Public Works Fee$ �� <br /> (425)257-8870 ' <br /> �.�Z7� J`7��'�7�(� Guaruntee5 <br /> OWNER NAME APPLI�ANT VAME <br /> ANDA�DRE55 _ =-;�J7 �- '�--.-' "-'.i."" ANDADDRESS: -":-�� <br /> �.-�,a <br /> „ � t, �.,� _ t . <br /> � 1 , `- <br /> �, -�rr . ._ _ , „� � t �: ` <br /> PHONE: �. _,,�.. PNONE: , .. � � . <br /> _ . _�n�� -�(.� - , <br /> TAXPARCELI.D.N PRQIECTADDRESS: __, ,._, _ . ., , <br /> i:nci�q_.iiii(ii�_'.. � � -� __ <br /> DESCRIPTION OF . � <br /> PROPOSED WORK: . � . ... � <br /> TO F�?Sifi�G otc 2 �� 2ooa <br /> PERMITCONDITIONS ' '- ` ' <br /> 1. All calls lor inspection shall be made 24 hours in advance. <br /> 2. Ail work shall be partormed in accordance with ihis permit and current City of Everetl Desiyn and Construction <br /> Standards and Specifications. � <br /> 3. Call Location Underground Service 48 hrs. belore you dig.TOLL FREE NUMBER 1-800-424-5555 L— <br /> �_,_. . _ . <br /> r <br /> ` - - _ : _ __ _ . '�A <br /> . �._ _ . . _*. _:_.. ...._ . V/ <br /> . ('i.� �. . � r�. -ti.�: �li. 1 � ,i �-.c' p.. j7•, ir 71^.�n. ,:.y:[� .•• �- t�r ::,;.. . . , ;�� , :. . <br /> Ir�.' ? i ���'o ���n ecntrr�l measui�.s per CiYy of Everutt StanlarJ<_: fcr s. �y'� <br /> LaynCN �eLC31^:1 �:^A*L^Z M�33�UL�A U(,ip2l cnnF•1arl:,n �='i :�1N �>Y^j�?�Jh F•tl^L-';_ .,_,..-. . iir <br /> co��ai =f C})E' ��c�CQ11'_. O <br /> All N<i•avate;i matr•riAl iri�m foundatinn, sidev2li� and drivc:�ays shal': be hWu" . ' <br /> %�ri�+L��t'?d, �ermir.t.�i :Jlt.;, N�� V39C1I1!] Q£ tnatPC181 1� 311QW�'d ��11 C�il� �ULidl.il.! <br /> . No dizt, mud, Lc":k: •x �ebzi= to he tracl:ed onto r��dyay. Z <br /> . tiC UU�1�I111�7 tia:erisl� tc• L•»: :tt3cked cn 3id�v3lks and aid?:+iik� t _ . - ... O <br /> � ! open for p�destrian iravel. <br /> . ?1d just wat�c met?c box 1" al?pve sid�.+alk �ICd��'. � <br /> . ?3v� �3rivav5y :rcm the fx: _ . �.c _ _ _ _ . . . <br /> . . . A 9(?C1:1k1FC 5:•s�em is ce,n . � . ._ � . -.. : �. - . � . ... . N <br /> . _.. . . .- .. .., ��, . . �. . O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> Tho undersigned owner/applicant hereby agrees to hold antl <br /> •� 4 +f� L� � save harm!ess Ihe City ol Everelt from any and all claims for <br /> h- � �' damages,costs,expenses,or causes oi aclion that may anse <br /> A ov Consvuc�ion ��e becauso o�installalion and maintenanco of the improvement or <br /> �� � ��^�� other right-of•way use hereto applied lor and ludhor agrees to <br /> �� / remove same upon notice irom the Cily and lo replace puhlic <br /> FINALINSPE ON propeltydamagedlhefeby. (� / <br /> Appwved as Constmctod Dale � /I lin/ (}.� /�_ �� L. -//2���b' <br /> �v �•�r l.���� ��wl F- <br /> SlgnalureolAppliwnl Dato <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 100 DAVS OF DATE PERMIT IS ISSUED AND 7HEFiEAFTER IS TO BE DILIGENTLY PURSUED <br /> TO COMPLETION.THIS PERMIT MAV 6E CANCELLED�Y TIiE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECi OVER 90 DAYS DURATION. <br /> U'1VP(l•�) DATA�AR.INC. <br />