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PUBi.IC IMORKS �a1e '}1i2?%21Q8 <br /> PublicWorksPermil# Pwn8o1-01B <br /> PERMIY Buildir�Permit# �0901-0'_0 <br /> PUBLIC WOHKS DEPARTM1^ENT planning Relerence a <br /> 3200 Cedar Slreel <br /> Evereit,WA 98201 Public Works Fee S 7 c � <br /> (425)257-8810 $-� �� <br /> , Guaramee S <br /> OWNERNAME -�PPLICAP;. :�-,'l� �-- <br /> ANDADDRESS: $']'E}J'�'�.�j\)� �jjF'C IA^1DADDFESS: <br /> lois cFOUti na <br /> FVERETT WA <br /> PHONE: Q?539BSSaQ PHONE: <br /> TAXPARCELI.O.N PROJECTADDRESS: <br /> ,)0969700003qnp 10 5 rROW! DF. <br /> DGSCFiIPTION OF <br /> PROPOSED WORK: 'lE41 GARi16E <br /> I <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall 6e made 24 hours in advance. <br /> 2. All work shall be pedormed in accordance with Ihis permit and current City of Everelt Design and Construclion <br /> Standards and Specilications. <br /> 3. Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424-5555 W` <br /> .. Do«;;;�,_e*� :n:�*. t��_ di�charge:l to ctceec . = <br /> _ . il)�"n" �"LC31011 �:GRtC01 IRt�39UC@5 �i�L' C1C}�' QI EV�'CNtC it3Nj3C�9 L�iC .C1311 �>3CC@1'� '^ <br /> . i;emove .•cosion contiol measuces ui�on completion of the neoiect j�ri�r to fiqal��„ v• <br /> �;q�coval o' the pecmit. '-"-" ' �i T_ � M <br /> - . All exc3vated mat=rial fiom foun•9ation, sidevalk and drivevay��h3,�]-�t�e ha}�led �_ V'� <br /> -,n appenved, peemitted site. No va�ting of mateeial is alluwd oiaz•,tli�Bu�ldfilg lot. � <br /> . No dirt, mud, cocks or debris to be Cxacked onto coadv�y. _- � <br /> . 1In I,i�il.riii�l materials to h� ;tar_ked on si�i��valks ;and ;idew3lk� tn t?e kept �7ea,y`nd ' <br /> - C� �r.� � <br /> _ _ r.._:i__�.Y�:_i❑ tL.{l'2�.. . i <br /> F-�i <br /> � ` O <br /> + <br /> Q -- � <br /> �. � <br /> crY l�! � <br /> r�� f lfA�] <br /> ���n.��1 <br /> _?(_1=_ cu i.ii � O <br /> c��-•'=. <br /> —�—� _ <br /> �- a <br /> ��� <br /> " � � ACKNOWLEDGEMENT OF CONDITIONS <br /> �; The undersigned o�vner'applicant hereby agrees lo hold and <br /> , savc harmless lhe City of Everott irom any and all claims for <br /> - 1�/ M�L - � C� damages,costs,ezpenses,or causes of action thal may arise <br /> nppro loi onsvuct�o me because of installalion and maintenance ol the improvemenl or <br /> _��_ n�Q� other nghl-of-way use hereto applied for and further agrces to <br /> � remova same upon notice Irom t Ciry and lo replace puLlic <br /> iINALINSiFC N p{6�,enydama thereby� <br /> Appwved as C, s(nided Date � � � � � <br /> � ��/� ` 9� , ���t�,C -c- . <br /> �_ _. Signa urc ol Appl¢a�� Dalo <br /> INORK AUTHORIZED 8Y THIS PERMIT MUST�E STARTED W ITHIN 180 DAVS OF DATE PERh11T IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUCD <br /> l0 COPdPLE110N.THIS PERMIT MAV�E CANCELLED�Y THE CITV UPON ANV STOPPAGE OP WOF1K ON THIS PROJECT OVER 90 DAYS DURATION. <br /> ���wr a��n onra�iaiv.wc <br />