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'3e� <br />/ v� <br />� <br />e. <br />PUB�i1C t�VOR►ZS <br />PI�RMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Streel <br />Everett, WA98201 <br />(425) 257-8810 <br />�::.,, _ _ .'_ <br />PHONE: � <br />TAR PARCEL I.D.p <br />DESCRIP710N OF . <br />PROPOSEDWORK:.'.�. -- _. +- _=.-__ <br />Date <br />Public Works Permil # <br />Building Permil # <br />Planning Reference # <br />Publit Works Fee S <br />Guarantee5 UmZ— <br />APPLICANT NAME <br />ANDADORESS: . <br />PHONE: <br />PROJECTADOfiES$: � <br />..... � -.. �� _.._ . .�.....:;�� Ti1E' j�3[':1 . . . <br />PERMIT CONDITIONS <br />�� <br />ZZ- �-01�-�3� <br />1. All calls for inspection shall be made 24 hours in advance. <br />2. AII work shall be pertormed in acwrdance with lhis permit and current City of Everell Design and Construction <br />Standards anci Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />. . - •.�;rh - -� --_.-- --... <br />__'. _-.-. ... 3;- . .. �-�.�: . . . _.,c .,,_,,.. <br />i:.�__,�.t, i _lit F �le.d c.. <br />-...° C'_'-� ' --... -- - -. - -�. ..._ �_-h'_ <br />.. <br />.. . .. . ., � _�i �. � .�.. �.�. �_. :i...._� �a.,._��,;., c:�, .,_ <br />,.: ...r. •.. <br />. . .. ��. .. � . _ . _ �. . ,. . _ . - <br />, ` � <br />., <br />� __ ACKNOWLEDGEt�1ENT OF CONDITIOVS <br />� The undersigned owner/applicant hereby agrees �o hold and <br />�/ � ��� � save harmless the City ol Everelt Irom any and all claims for <br />i A pro d lor ConsW on Date damages, costs, ezpenses, or causes o� action thal may arise <br />because ol installation and maintenance ot the improvement or <br />% other ngh4of-way use hereto applied br and �uriher agrees to <br />removo same upon nolice �rom the City and to replace publ�c <br />FINALINSPECTION pro e damaged hereby. <br />Approved as Constmctetl Date � � <br />; ��L� � _ -�/ ��i� �- <br />i nalureolAp licant Dato <br />INOPKAUTHORIZED BYTHIS PERA7IT MUST BE STARTED WITHIN 180 DAYS OF D,\7E PERMIT IS ISSUEDAND THEREAF7ER IS TO BE DILIGEN7LY PURSUEJ <br />?O COMPLETION. THIS PEflM1T MAV �E CANCELLED 6Y THE CITV UPON ANV ST(�PPAGE OI� WORK ON THIS PROJECT OVER 90 DAVS DURATION. <br />[P�YF I��Ofi! OATABFfl. ING <br />