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P <br /> PUBL,lC WOR1�:. Da1 <br /> Put!ic Works Permit r � <br /> PE�Iw I T Bwlding Permil a <br /> PUBLIC WORKS DEPARTMENT Planning Relerence t. <br /> 3200 Cedar Street <br /> Everett,WA 98201 Public Works Fee S � � � <br /> (425)257-0810 <br /> Guarantee S <br /> OWNER NAME ' - � ��'' �" APPLICANT NAtdE <br /> ANDADDRES$0.���.,. . . . .� ,,. , �- ANDADDRrSS: <br /> PHONE' PHONE. ' I TjCI S �� ���' �� �l �V��/L lQL <br /> TAXPARCELI.D. p PROJECTADDRE . - �� -�j ���11 � J <br /> DESCRIPTION OF'�' ' � � " - <br /> PROPOSED WORN: <br /> PERMIT CONDITIONS <br /> i. All calls for inspection shall be made 24 hours in advance -phone (425) 257-6810 <br /> 2. All work shall be perlormed in accordance wilh Ihis permit and current City of Everetl Design and Conslruction <br /> Standards and Specifications. <br /> 3. Call Localion Underground Service 48 hrs. before you dig. TOLL FREE NUMBEA 1•800-424-5555 <br /> . . . , . . � . � � � . . .. . � � . . . . . , � <br /> ' • � <br /> W <br /> 0 <br /> .t( Lli `7 <br /> ,,,x� ,+�t�, � <br /> O <br /> ��p <br /> Vd <br /> ��J! <br /> Qr.. <br /> i ACKNOWLEDGEMENT OF CONDITIONS <br /> �'r��- /� � The undersi ned owner/a Imant hereL a rees to hold and <br /> -�`%./, r/ r� ���, _�,, � t� �i,: 9 PP� Y 9 <br /> .� L,j,�v�l�/� � ��1.- (�' � "j save harmless the Ciry of Everett from any and all claims for <br /> � T`— damages,r.osts,expenses.or causes of action that may arise <br /> TGP��ovedlorConsimclion Dale <br /> because of installation and maintenance of ihe improvement or <br /> /� other righl-otway use hereto applied lor and�urther agrees to <br /> �'� , /i/,�,/��,,.,��-- removc same upoo�nollce from the City anC to replace public <br /> L INSPECTION pmperty dar7iaged thereby. � <br /> .. Agpmvetl.s Consimded Dale i�; .� �� � � <br /> "" ,�9�". _ -� 1( 1�:� ;�:.. <br /> �-i�: - c�� - � '-- �-- . <br /> Sign�lu���Di,Appqcant Date� � <br /> YJORK AUiHOPIZED 6V TI IIS PEflL71T f.1UST F3F STARTED 1YITHIN 100 DAVS OF DATE PERMIT IS9S.SUED AND THEREAFTEP.IS TO 8E DILIGENTLY PURSUED <br /> 7G CO�dPLfTION.THI`i ffll!d1T fdAY!3G CANCELL[D[1Y THE fITY UPON ANY STOPPAGE OFVJORK ON THIS PROJEC-OVEI7 90 DAYS DURATION. <br />