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PUBLlC WORKS Date ;;j�i�,:p�_i�; <br /> �E R M 1 T Public Works Permil xPWO 20 2—(1;t� <br /> BuiltlingPermits E0302-0:.'!i <br /> PUBLIr,WORKS DEPARTMENT Planning Rclerence a <br /> 3200 Cedar Slreel <br /> Evcretl,WA 98201 Public Works Fcc S ��4 . ����� . i�`-� <br /> c"ZSif;'�pIPSTING MNR 18 2003 �.�„��-►,�z �z�,3oo. 0� <br /> OWNERNAM�VEFETT Sl'HUOL llISTRICT A�PLICANTNAME <br /> ANDADDRES - ANDADDRESS: <br /> 4 7 30 i:OLP�Y AVE <br /> EVEFE;T WA 9� U,� <br /> PHONe: q�5.'•504730 Pr+oHe: �7 <br /> C�" oC <br /> TA%PAqCEL1.D.a PqOJECTADO(lESS: <br /> U0437Er'+;1n100pti ���'.? EVEFETT AVE <br /> D[SCRIPiION OF <br /> PROPOSEDWORKNEIti 1;AINT. � VEHI�-'i�E IdA�I�T. f-.iliLUIiVGG <br /> PERMIT CONDITIONS <br /> 1. All calis for inspection shall be made 24 hours in advance •phone (425)2b��8�1II"T AVE F� RA INIE� AVE <br /> 2. All work shall be performed in accordance wilh Ihis permit and current City of Everell Design and Construction <br /> Standards and Specifications. <br /> 3. Call Localion Underground Service 48 hrs. be(ore you dig. TOLL FREE NUMBER 1-800-424-5555 <br /> a . a��; ,.,_i ai,nio„e�i ,,1an �_la� ed a,lb,ii� . W <br /> � <br /> vI <br /> W <br /> O <br /> �� � <br /> ��"�' ��' �'� Z <br /> � �= �,, . <br /> O <br /> ;��J cy <br /> ;��,-y'> ` �� 1� 2� " � <br /> � f/ O <br /> „�:.�y ` a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> , ; <br /> . �(�q I D� The undersigned owneCapplicant hereby agrees to hold and � <br /> ` save harmless the City of Everett from any and all claims for <br /> Approve�d lor Cons�mcNon Dat damages,cosis,expenses,or causes of action ihat may arise <br /> ,,: L� ;��,,�� becauso ol inslallation and maiNenance of the improvement or <br /> /, , ���_--� � �/ U3 olher right•ol-way uso hereto applied lor and lurther agree,to <br /> ��� remove same upon notice Irom ihe City and to replaca public <br /> FINAL INSPECTION prope/ ereby. <br /> Approvetl as ConstructeA Dale <br /> - - o s' � z <br /> SitjnaWre.uf pplKant Dalo <br /> '/ <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED\VITHIN 180 DAYS OF D ERMIT IS ISSUED AND TIIEREAFTEFi IS TO BE DILIGENTLY PURSUED <br /> IW COMPLEiION.THIS PERMIT MAY�E CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 D4VS OURATION. <br />` 'J <br />� ��A��� <br />