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<br /> ����� iy �,�_:, .. ,_I:4;1.� � ..��; PublicWorksPermita P4d0509 0�'-�
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<br /> � PUBLIC WORKS DFpA RT �; CI 1
<br /> 3200 Cedar Slr�eel���J4u�'� Planning Rclereno; ��
<br /> Everett,1NA 9820t Public Works Fee S -- ,
<br /> (a2s)zs�-asio F'/L al;.�, -�- . "'
<br /> 1 t�j��. ;i,j j,� Guarantec5
<br /> � �i F,�
<br /> .�:'Rl;-fi NAME - ` APPLICANT NA
<br /> nr:u�:uor�Ess:3925 9oTH PL SE nNonooaEss����
<br /> qF!�,*j��{�� "s;:O.C�i
<br /> 9�EVERETT63p WA 191i"'"6 .��.1'.ij
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<br /> Cl-iL-.i< �1.��i!.41
<br /> TAXPARCELI.D.a ' ^" � • PqOJECTAD�RESS:l(����g HOLZ,Y DF
<br /> NEW &GUSE PLRN - �• r �
<br /> I�[SCRIFTION OF
<br /> PROPOSED WORK:
<br /> TO POSTING ��L 1 8 2005
<br /> PEHh11-fCONDITIONS fI'-'"� ' =�--�• -..:- �,�.._ . .
<br /> 1. All calls(or inspeclion shall be made 24 hours in advance- phone (425) 257-8810
<br /> 2 All work shall be per(ormed in accordance with ihis permit and current City ol Evereu De;iqn ond Con;t-ucticn
<br /> Standards and Speci(ications.
<br /> 3. Cail Localion Underground Service 48 hre. before you dig. TOLL FREE NUMBER 1-800-424•5555
<br /> : Conner_t ro�,ftop dnwn;p��uts tu the dcainaga ey.;ran po�vi�ir-_,+ i�.c thi; lot. - �
<br /> �nstall. eiosion control mea3ue-r� as detecmined by the FuY-1ic ❑urk� Inspe��toc, ;;u_n ' �
<br /> ,�ilt fence, straw bales, �craler� oc erosioii blankets. �/�
<br /> . F.emove erosion cuntrol measuces upon completi�n of the pcoject prioc to final �++
<br /> r,:>coval of tl�e pecmit.
<br /> 7. J,11 excavated mateeial from Youndation, ssd�W31�( an�i dtic•�vays ahall be hauled tr, W
<br /> r spproved, peemitted site. No �+asting of mat�ial is allorled on this buildiny lot .
<br /> 4. r�nra� +- MUY;ILTE�? taATEr D , �
<br /> �n�? �<,�-� cric •-- �'[RL T Y r �_rn���ct ;n� peovi�l� n fur *_lu:: t�uildin���� .,,,3r,:�.
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<br /> ACKNOWLEDGEMENT OF CONDITIONS
<br /> / � � / "�..,�� / JO, The undcrsigned owner/applicant hereby agrees to ho!d and
<br /> /L�rK �J �� save harmless the Ciry of Evere�t Irom any and all claims for
<br /> Apprwed lor Co tmctiory�� Date damages,costs,expenses,or causes of acfion Ihat may drise
<br /> � Uecause ol installation antl maintenance of the impwvemeM or
<br /> - , ��� other iighhot-way use hereto applied br and luriher agrees to
<br /> CINSPECTION '��� remove same upan notice from Ihe City antl to mplace public
<br /> propehy dmna ed hereby.
<br /> Approvetl as Conslmded Date
<br /> 7'-/Z-Gi _�_ il./� /� // Z�l Z v-�-'S
<br /> SIgn�Nre ol Appl�c� �I � � '- .
<br /> '•%i i i nl! �6 I II l:;i � 1 i� ' i:bl ! I (�i!�t i � �qp p,p (�I-D IL I I ii I 135U'p V�'� IH[REAFTER IS TO�E DILIGENTIY pURSUED �
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