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i <br /> � <br /> PIJBLIC 1lVORKS Date <br /> Public t7orks Permil t <br /> p�RMIT I DuildingPermi!# <br /> PUE3L'C Vl��RKS DEPARTMENT Planning Reference# <br /> 320�Cetlar SUeet <br /> Everea.WA 98201 Public Works Fee 5 <br /> (425)2u7-8810 <br /> Guaramee S <br /> OWNERNNdE APPUCANTNAME <br /> ANDAD�PESS: - - ANDAD�RESS: - - <br /> ' - _''"' ' � _ <br /> = � ; == TO POSTINf��..�..o.2ooa_..... <br /> PHONE: � � PMONE: <br /> TA%PARCEI I.D.N PROJECTADDRESS. <br /> DES^RIPTION OF <br /> PROPOSEO WORK: � � � <br /> PERMIT CONDITIONS - <br /> 1. All calls tor inspection shall be made 24 i�ours in advance. <br /> 2. All work shall be petormed in accordan:e v:ith this parmit�nd current City of Everell Design and Construction <br /> Standards�nd Spe.:ifications. <br /> 3. Call Location Underground Service 48 hrs.betore you dig.TOLL FREE NUMBER 1-800-424-5555 W` <br /> r <br /> � <br /> t �i��. ..� ❑ "'i Il L_. :��. n L �� � '-' < i i t �_�. . .j.�, �.-.� � W <br /> . . . _ . . �: . . . .. . _ <br /> n��vF rL � �nn r��n e��l Rea uiF , np��p rnmp7� i.�n ���t thu pr��j��t prio, <br /> . -�>73'. ::I '!1N p�Ctc1*.. O <br /> . ..'.1 c..;rava[e�i �atecisl icom routt�iatinn, sidew=_14: and ,{c_ye�,.}•� .iiail h�� nsu:. <br /> iq�rc,ve•c!, f��rmitru,t ::ite. lto Wnstinq of matt•r.�i:,- . � . _ .. .. . . . ,._.. � <br /> ' � dirt, mnd, r�_,cl-^ ��r �iek�r.�.., ro ha rr:�"k<<i nir � <br /> . ?lo buil:;ing na*.ecials to k�.ec�t_:l:e�d on �i6?w;. � <br /> ;p<� {„� r.a,j�3teian teaval. <br /> . ?:ci�u�t water metr,c t�c�:i i" abn��e sidevslk qca�i�-. <br /> . r.emnve ard ce�:lace curY.�, !7Utt@C and -idev:�lk - - � <br /> � . '05A 6 '05 cn this pe•�c�esal's _co,Lsge as ri;_�.. . � <br /> . -. all u�tu;��i �icic�_ul•a .am9 .s:i;' '>c'-•F:=r. ar �iana•� O <br /> ?av:. dL':�.-.,,.�y pY��r.� th.. �ir��t n�..�,P.-, •y liro� ;n,. <br /> li. <br /> ACKNOVJLEDGEMENT OF CONDITIONS <br /> � //� " The undersigned ownerlapplicant hereby agrees to hold and <br /> �i7� , •/���� %z � �� save hartnless tho Ciry ol Everetl Irom any and atl claim;lor <br /> �K=� damages,costs,expenses,or causes ol action Ihal may arise <br /> ..dppm d� Consimc��on�� am �/ because ol installalion and maintenance ol tho improvement or <br /> �) other righl-ol•way use hero!o applied for and lunher agrces lo <br /> 2—6 — �a remove samo upon notice Irom the City end to replace puUi�c <br /> FINALINSPE i0rl proq6rtydamagetlthoreby ,: <br /> Appmved n onsiruded Dale - � � ' � . � <br /> , ._G ._. � � . -•— � L ) �. . 1 <br /> r ' _ ' <br /> $ignatwa ol Applican� Du o <br /> ^ � <br /> WORKAUTHORIZEDDVTHISPERMITMUSTBESTARTEDWITHINi800AVSOF�AT[PERIdITISI55UE�ANDTHEREAfTER6TO�EDIUGEMLVPURSU[U 1�\ <br /> TOCOMPLETION.THISPERMITMAYBECANCELLEDBYTHECffYUFONAIJVSTOPPAG[OPP+URKONiHISPROJECiOVGN�ODAV50URH710N. � <br /> erwr P�oS] onrnonn.��:c� <br />