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PUBLIC WORKS Date •: � <br /> / <br /> PubliC Works Permit#��" _ - � , <br /> PE R M I T Building Permit:. <br /> PUPLIC WORKS DEPARTMENT Planning Reference# <br /> 3200 Cedar SVeet <br /> Evereti,WA 98201 Public Works Fee S _- . <br /> (425)257-8810 �"� <br /> Guaran�ee 5 �y��j` ��� <br /> �ii <br /> O%NGRNAM .�.� ,_1�,_�� APPLICANTNAPdL' .aR �.l;r_:: <br /> AND ADDR� ANG ADDRESSa Y ' <br /> 1333 Lomha[�i ..ve. 1?':7 Lomb.acd ... _ . <br /> r.veCett ..-. `c�. _ �Pa�c,rt '+3 - -`��= <br /> PHONE Q�S.3_'I1:I�� PNONE �c°,�<;_^.'.' 1 'iG <br /> lA%PARCEI.I.G.a PROJECT ADOR�S$:,�.: . <br /> -�.7�t�iL�: aP" <br /> DESCRIPTION GF <br /> PROPOSED WORK: <br /> 1:'. _ _.._. :i�� . _.._ _ . . ..._ ... :._ __. -� . _ ,- _ _ .. _< . <br /> ��:u:h. <br /> PERMIT CONDITIONS <br /> i. All calls (or inspection shall be made 24 hours in advance - phone (425) 257�8810 <br /> 2. All work shall be pertormed in accurdznce with ihis permil and current Ciry ot Everett Design and Construction <br /> Standards and Specifications. <br /> 3. Call Location Underground Servi�e 48 Frs.betore ycu dig. TOLL FREE NUMBER 1•800-424-55R5 <br /> W <br /> . . . � LII�' I ❑C�'. .' -�'r __ _ ..__.._ `_'_ "' "_ ___ f=.. . _: ... . .. _c ' " � <br /> . .. .... ...1�� tn ._:C19!'1 _ .._ i� _ ,_ _ t,.rl__ ;.__ _ ,. .:1:�E ..,._ . ... i"' �1 vI/ <br /> ��r� -= iii <br /> r. x <br /> r, .' O <br /> -. i 1'. <br /> �.' <br /> fF � <br /> �� ` <br /> i� <br /> �1,I � <br /> �I -_. �w <br /> , -. ����,�' Y�\/ <br /> _ r/ <br /> __ a <br /> ACI<NOWLEDGEMENT OF CONDITIONS <br /> _,___, „ <br /> � <br /> � " lha undersigned owner/applicanl hereby agrees to hold and <br /> � `v -' , �,..� � , -� save harmless ihe City ol Everett trom any and all claims for <br /> - �� pm e r Conslr tion � Da)• damages,cos�s,expenses,or causes of action Ihai may arise <br /> �� � I because of installation and maintenance of the improvement or <br /> / o�her right-of-way use here�o applied for and further agrees to <br /> � �G'/��/Z� same upon notice from the City and to replace public <br /> FINAL INSP iON r-- —7 p opert damaged iher by. <br /> Appmved as nstructed Da�e ��� �._ ��..-r-� <br /> Si tal � anl D.11e <br /> l'fOHK AUl HOR2fL�BY THIS PCf71.111 A1UST(3F STAIiT[D 6YITHIN 1P.�DAYS OF f7ATE PER�d1T IS ISSUFD AND THEREAFLER IS TO BE DILIGENTLV PUFSUFD <br /> 10 CG�S�=f f'_710N TI115 PERI,11i 1.1,1'r DE CANCLLI CD 6V iHF CI1Y'UPON ANY STOPP,1GE OF WORK ON THIS PROJECT OVER 30 DAVS DURATION_ <br />