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L..,e <br /> � PUBLIC WORKS ' <br /> J <br /> /� C I Public lM1brks Permit# <br /> '��-��' �G��'� BuildingPe�mi'# <br /> PUBLIC WORKS DEPARTMENT planning Relerence�' <br /> 3200 Cedar Slreel <br /> Everett,WA 98201 public Works Fec 5 <br /> (425)257-BB70 <br /> I Guaranlee S — <br /> rOWNERNAME APPLICANTNAME i <br /> IANDADDRESS: T'�"�'.+ -� ANDADDRESS: <br /> i � _ . [ii<;•43?i i_:t. <br /> . _.S_F'�r.1' � <br /> PHONE: . ,4 s.�QSSQh PHOKE: <br /> TAxPARCELI,D.# . - ... PRQIECTADDRESF' .,iit� ' ".Ii; C''- <br /> ' <br /> DESCRIPTION OF � <br /> PROPOSED WORK: � � <br /> �— _ —_ _. . _ . . _ . . —. .. _—. . __. <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours:n advance. <br /> 2. All work shall 6e performed in accordance with lnis permit and current Cily of Everell Design and Consiruction <br /> Slandards and Specifications. � ! <br /> 3. Call Location Underground Service 48 hrs. before you diq.TOLL FREE NUMBER 1-800-424-5555 <br /> � <br /> . . . . � � . . . - � � � ��/� <br /> .. . . � ���n - i . . �� �, u;�. .. ,�� -�n _ �:e{� .�: ,•-n . ,. . . . . . . . _ " <br /> ' R� lf 1�iP (IPLP1lY• �.. . . : � : . . .i � W <br /> t aYc�v�t d Td3CP1'17I SCCIC fouedstic�n, �ids���lY, 8f1� aC1YPtd8]/Y,^j.h�1;2-� h�uled • <br /> � <br /> :.roved, pacmitt?a aite. iJc v>�ting af matecial is allored nce�ith�B: :ld�q 1:� O <br /> dact, m��r., ror.ks ��r. ,iahrx� t�� b� tC.iCICP� ontn madvay. ` � ' <br /> ruil�iin�t marer.ials to he �tark.Nd on Qid3+.f;lk� and �iri�*ralks tr he {���t �leaP <br /> � i.�: Z <br /> -.:�. �-. � ; a:=,7 , � <br /> F. <br /> O <br /> 'rA <br /> �� V+ <br /> O <br /> a <br /> -- -- ACKNOWLEDGEMENTOFCONDITIONS <br /> � , / / � The undersigned ownedapplicant hereby agrees to holtl and <br /> �� �.' , � �� ,��, � �-��;j� ,��)�,' save harmless Ihe Ciry of Everett irom any and all claims for <br /> damages,costs,expenses,or causes ol action Ihat may arise <br /> Appro � � Cons�maion a�e ,� because ol installation and maintenance ol Ihe improvement or <br /> � —���/�� other nght-ol-way use herelo apPlied lor and lurther agrees to <br /> � S�� --Q remove samo upon notice fmm the City and lo replace public <br /> FI AL INSPE I N pfopetty damagetl Ihereby. <br /> � Appmved as nstructetl Date . . . <br /> I � . .� _._. _ . . .. � .. . _ <br /> �_ _ Signatureo�Apphcnnt Date <br /> �^JORK AUTHORIZED�Y THIS PERMIT MUS7 PE STARTED WITHIN 780 DAVS OF DATE PEPAIIT IS ISSUED AND THEREAFTER IS TO BE DIUGENTLV PURSUEO <br /> TO C01dPLETION.THIS PERh11T MAV OE CANCELLF.D 3Y THH CIi��UPON ANV STOPPAGE OF WORK ON THIS PROJ[CT OVLR 90 DAYS�UFATION. <br /> ,�r�vr o-c�a <br /> untaom� rt�c <br />