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PUBLIC WORKS PER6NIT <br />City of Everett Public Works Department <br />� �. 3200 Cedar Street <br />l,� �,L�� Everett, WA 98201 <br />(425) 257-88"0 <br />OWNER NAME AND ADDRESS: <br />PUBLIC UTILITY DIST 1 SNO C <br />2320 CAIIFORNIA <br />EVERETT WA 98201 <br />PHONE: <br />AX FARCEL ID # 28050500204500 <br />DESCRIPTION OF PROPOSED WORK: <br />SITEWORK - SNOHOMISH PUD <br />Date: <br />Public Works Permit #: <br />Buildinp Fermit #; <br />Planning Reference #: <br />Public Works Fee 3: <br />Other �: <br />APPLICANT NAME AND ADDP.ESS: <br />PUBLIC UTILITY �IST 1 SNO C <br />2320 CALIFORNIA <br />EVERETT WA 98201 <br />PHONE: <br />SI7E ADDRESS: ?.221 LOWELL RD <br />12l13/2012 <br />P W 1212-007 <br />$ 45.00 <br />PERfJIIT CONDITIONS <br />1. All calls for inspection shall be made 24 hours in advance. <br />7_. All work shall be performed in accordance with the permit and current City of Everett Design and Construction Standards <br />and Specifications. <br />3. Call Location Underground Service 48 hrs be:fore you dig. TOLL FREE NUMBER 811 � <br />4. Per approved plan. <br />Your Public Works Inspector is Randy Allen. Cail him at 42533y-7403 for questions and ir��pections <br />�„ <br />Date <br />� 2 � '�7r <br />INAL INSPE�%I IUrv <br />Approved as Constructed <br />—� <br />�, , ,�., , �. ji 11 ;` � � <br />�� � i�>) �'�� 1-� <br />�ll DEC 1 a �012 <br />� <br />::1"CY Cl� fiV1:.Rl=:l..l. <br />P��rinr, Scrvicc� <br />W <br />� <br />� <br />� <br />� <br />ti <br />z <br />0 <br />� <br />a <br />ACKNOWLEDGEMENT OF CONDi �:�NS <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless the City of Everelt trom any and all claims (or <br />damages, cosis, expenses, or causes of action ihal may arise <br />because of installation and maintenance of the improvement <br />or other right-of-way use herelo applied for and further agrees <br />to remove same upon nolice from �he Cily and to replace <br />public properly damaged thereby. <br />l�J,� Q. n ��tl �� l� �. <br />Signalure of Applicant Date <br />'.VOIiK AUTHORIZED BY THIS PERMIT P1USf 8E STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFlER IS TO BE DILIGENTLY <br />PURSUED TO COi�iPLETION. THIS P[Rh1IT MAY 6E CANCELLED BY THE CRY UPON ANY STOPPAGE OF WORK ON THIS PRO]ECi OVER 90 DAYS DURATION. <br />