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, , <br /> 9�g�zo,,,. �; <br /> R���'� r■O��\V Date p�f05fi: i: � <br /> Public Wo� s Permi� = "��'S'r-- " . <br /> PE R NI I'i' Buildmg Permit# <br /> FUBLIC WORKS DEPARTMENT Planning Re!erenc+� �� <br /> d200 Cedar Slreel -- . • <br /> Everetl,WA 98201 Public Woi�., Pe••.� <br /> (425)25?-B87&�ry ��.��ppp ^ Ir•.r (� <br /> '" ��'�I.iit��i �_��:_�_C'_/ '..'J��d(df1IL'(: ' <br /> 1 I1VTF.W �^i�T:T"rAf T!',G�' T.i.-" _ <br /> OWN[R N41dE APPLICANi NA�dE <br /> nNDADDRES��� ��" ��}4-Z ANDADDRFSS: <br /> �f:�rr w.� 4e.z�:> <br /> 9255:1017f, <br /> PHONE: PNOf1E <br /> I '1 fl "!1 `l- <br /> raxPnnce�i.nu tfEWlAO'.�5E - PASTC 16P� raodecrnooRess�. <br /> DfSCRIPTION OF <br /> PROPOSED WOHK: <br /> i; 7 iC � - � _�.,.- <br /> PERMIT CONDITIONS "`�'�'�' .'IRST hDG': <br /> 1. All calls for inspection shall be made 24 hours in advance - phone �425) 257-86�0 <br /> 2. All work shall 6e performsd in accordance wiih this permit and current City ot Everetl De�;ign and Cons,uuction <br /> Stan�lards and Specifications. <br /> 3. Call Localion Underground Service 48 hrs.before you dig. TOLL FREE NUP�IBER 1-800-424-5555 <br /> .. �_�:'llRdCt 82��8 5PM?C [7FC ('l�Y St3q��3C� ��5 pl)!� riti�� f.�lu, 1 [ 1 <br /> L i ' � 1� t � � • <br /> . Th> •�ontractoe must meet vith the Fublic 4�o�;;s in::pec_c: . . ci;:: .��:. _ , � <br /> ��Cdlild�3� LC�Ilt1I1�7 �JCyOC Y�: �'.ri71I1111l1O Y_�lE �•C9)P."L . <br /> � <br /> �� . F��' f . �� �.unnY` r.�is* :__��t.,c �-�.t *. ; ,-�.�,;r .,. .-. . ..:_ltrat.ion syste::. =.. .-_ . � �/� <br /> "! ..' _L�_ " " .� . :L::. :aR1.__ .-_ ... .... . Vlr <br /> � <br /> J � . I ' O <br /> r <br /> Z <br /> ..w �n <br /> O <br /> � � H <br /> r, us : � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEME�lT QF CONDITIONS <br /> ?he undersi�ned ownerlapplicant hereby agrees to hotd and <br /> x � '7'1�, / � /� j/l j save harmless the Citv of Everett from any and all clai.ns for <br /> i npp e .or Construcuon , Date damages.costs,expensec,or causes of action that may arise <br /> because of installation and maiMenance ol the impiovemeni or <br /> ��` �,' . � other righl-of�way use hereto applied lor and furiher agrees to <br /> � f -7 .� L"1 remove sam p notice from tha Ciry and to replace public <br /> FINAL INS CTION property d Ihereby. <br /> Approvotl.. Cunslmcted Dole � <br /> �" ----���-OS — ---- <br /> Sg;naWre ol Applican� Daie <br /> l'/i i�l:;�UTIIORIZED UV THIS PFR1.1I71dU5T BE Si�(7TGD IVITHIN 7d0 DAvS OF DATE PER�dIT IS:SSUED AND THEREAFTER IS TO 8E DILIGENTLV PURSUFD <br /> l0 COLiPI FT:ON THIS PFHIdIT PAAV OG CA'�CLI L[D f3Y THE UTV UPON ANY STOPPAGE OF 170RK ON THIS PROJECT OVER 90 DAYS�URATION. <br />