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PUBL1� WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTPAENT <br />3200 Cedor Sireet <br />Everclt, WA 9&201 <br />(425) 257-8810 <br />IWNEFNAME GT$LCA LESI.EY d P.OSE.�'SAF?Y APPUCANTNAtdE <br />.NDADDRESS: �307 Lu4TELL kG �'NDADDRESS: <br />EVEFETT WA 982 f.r; I n <br />aHONE: 9252807519 <br />TAXPAflCELI.D.a OOSOOGOOU01700 <br />DESCRIPTION OF <br />PROPOSED WO�K: <br />PERMIT CONDITIONS <br />PHONE: <br />Date <br />�,:blic Works Permit a <br />Building Permit a <br />Planning Relerence N <br />Public Works Fee S <br />Guarantee 5 <br />PROJECTADDRESS �j;j�7 �,tiiJ$i,7, F:CI <br />�ii9izoos <br />PWG507-030 <br />1. All calls for inspection shall be made 24 hours i� advance • phone (425) 257-8810 <br />2 All work shall br performed in accordance with Ltiis permit and current City o� Everett Design and Construction <br />Standards and Specifications. <br />3. Call Localion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424-5555 <br />t. _''-ac� retainin:i wall at e.1.;c. oi •.cistin9 a�F�h.�lr <br />. ,. . � r. l . ., � - - .5 ft. IL'��m r_ant«c lln�) <br />525.O�1 <br />, <br />,:�('� <br />� � <br />CI] _- <br />_� <br />; <br />� _� <br />r� <br />��� �', N <br />,�n G �n <br />:3Q� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />/ <br />The undersigned ownedapplicant hereby ayrees to hold and <br />save harmless ihe Gity ot Everetl frorn any and all claims tor <br />damac�es, costs, expenses, or causes of action that may arise <br />because ot installation and maintenance of the improvemcnt or <br />other righbol-way use hereto applied for and lurther agrees to <br />remove same upon nolice imm the City and to replace public <br />prope damaged Ihereby. <br />Signat re o�ica� Date <br />IVORK �llll HOflIZED BY THIS PERMIT h1UST �[ STAPTED NlITH�N 1�0 DAYS OF UATE PERMIT IS ISSUED AND THEREAFTEH IS TO B[ DIUGENTLY PURSUED <br />TO CO.'.'�PL[TION. THIS PERI.!IT M11AY BF. C�WCfLL[D BV THE CITV UPON AN1' S70PPAGE OF WOPK ON THIS PROJECT OVER 90 DAVS DURATION. � Y�L <br />L <br />