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Y <br /> PUBLIC WORKS °a'� 11,:���,��; <br /> PERMITPublicWorksPermitk pW0311-002 <br /> Building Permi�p <br /> PUBLIC W(;RKS DEPARTMEN7 Planning Reference a <br /> 3200 Cedar Street <br /> Everett,WA 98201 Public Works Fee S 525.00 <br /> (425)257-8910 <br /> Guarantee 5 <br /> OWNER NAME - APpLICANT NAME <br /> ANDADDRESS: 3308 Lombacd kvenue ANDADDRESS: <br /> E��TT WA 982U1 <br /> 9252527719 <br /> PHONE' PHONE: <br /> TA%PARCELI.D.p PROJECTAO�RESS: �-� om �3c- Avenue <br /> DESCRIPTION OF ' ' <br /> PROPOSED W017K: <br /> PEFMIT CONDITIONS <br /> 1. All calls tor inspection shall be made 24 hours in advance -phone (425)257-0810 <br /> 2. All work shall be performed in accordance wilh Ihis permit and current City of Everelt Design and Construclion <br /> Standards and Specificalions. <br /> 3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800-424-5555 <br /> 9. Nev Driveway shall not e:cce•eJ 2l,i' in width. The new diiveuay shall be pave!1 fi��m W <br /> the Lack of sidevalk r_o at least 20' beyond the feunt pco�;eety line. � <br /> 5• Please setup a me�tin_y vith [he Public Woeks Inspectc�L prinx tu staetin4 ��rk. 7'h? � <br /> nspectoes r_ell phone numi?ee is 3�n-7qp�, /A <br /> 6. Keep city stce�ts i�1�=an ;t ail t.ime� ducning con�tcucr?yon, VM/ <br /> W <br /> O <br /> � <br /> �i t ll-04-03 1:04PM Z <br /> ��„1`r C'� ��(C�a/� n ai�oo� O <br /> �� �Rru� 2s.eo <br /> �a¢�os TOTAL <<.oo � <br /> CASM ^ <br /> A OM5�62 �O <br /> Q. <br /> -> / <br /> ��� ; - G��� ii,�� ; �,.��' � • t`" il L <br /> ./ <br /> /� / ACKNOWLEDGEMENT OF CONDITIONS <br /> , `�/i_'� �1.,V !�/Q��� The undersigned owner/applicant hcreby agrees to hold and <br /> y '���a�� � � savc harmless Ihe City ol Everett Irom any and all claims br <br /> np rovetl 1or Consimciion oa�e damages,cosls,oxpenses,or causes ol action thal may aiic� <br /> because ol installation and maintenance of the improvement or <br /> other right-ol-way usc hereb applied!or and lurther agrer.s to <br /> re�ove same upon notice Irom the City and lo replace public <br /> FINAL INSPECTION property damaged:hcreby. , <br /> Appmvetl as Conslructetl Dale / <br /> ���'-����G /J - '��� <br /> Signature of Appl�ca� Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WiTFIIN 180 DAVS OF DATE PERMIT IS ISSUED ANU THEREAFTER IS TO BE DILIGENTLY PURSUED <br /> TO C01dPLETION.7HIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />