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� ` <br />� <br />PUB�ic wo�Ks <br />PERlVIIT <br />PUDLIC WOFKS DEPARTMENT <br />3200 Cedar Stmcl <br />Everen, WA 98207 <br />(425) 257-8870 <br />OWNEFNAME CHANNING UENNls <br />ANDADDRE55: <br />1531 LAKE MOUNT DR <br />SNOHOMISH WA 90^290 <br />aiioNe: ( 360 ) 334-5347 <br />a <br />APPLICANT NAME <br />ANDAODFESS: <br />PHONE: <br />PROJECT <br />DESCRIPTIONOF ADDITION TO ExiSTING rI,INIC <br />PROPOSEO VJORN: <br />PW <br />oate 5/1::/3001 <br />PubPCWorksPermita PW�105-028 <br />Building Pcrmii a <br />Planning Relcrencc q <br />Public Works Fec 5 <br />Guaranir e S <br />B0104-03"s <br />$45.00 <br />PERMIT CONDITIONS <br />1. All calls Icr inspectinn shall be made 24 hours in advance - phone (425) 257•8810 <br />2. All work shall be performed in accordance wi;h Ihis permi� and current City ot Evere�� Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />4. Keep ci.ty streets and alieys ciean at all ti.mes. <br />5. Pave e�i�tinG 35'X20' qravel pail:inG at reai oY buil.diny witti �iew <br />asphalt. <br />�-30-;';1 <br />t <br />t:UILD <br />S��CHG <br />if <br />��uc <br />_,. .1 �. <br />1:4_Ptl <br />0].6kG33 <br />693.45 <br />4.5J <br />0]OSG2c <br />�rS.00: <br />iG^,y[. <br />i"y .'7 <br />W <br />� <br />v+ <br />W <br />� <br />� <br />� <br />.'J-' __. � ;. ��:.:�:. <br />� <br />�A <br />1.V <br />ACKNOWLEDGENENT OF CONDITIONS <br />The unde�SigncA ownodaoplicaN hereby agrees lo hold and <br />save harmless the Cily ol Everett fmm any antl all daims lor <br />Uamages, costs, eapenses, or causes ol action that may arise <br />because of ins�allation antl maintenance of the impmvemuN or <br />other right-ol-way use hereto applietl lor and lurther agrees to <br />remove sr,me upon nolice imm ihe Clty and lo replace public <br />prop , nmaged �hcreb <br />\___. —_ _// _____— <br />-- �. ______ . <br />$ig�alure ol Apphcanl Oale <br />CiORK AUTHORIZEU f3Y THIS P[RhJT P,1UST BE STARTLD LVIiHIN 1�0 DAYS OF DATE PER1dlT IS ISSUE� AND THEREAFTER IS TO BE DILIGENTLY PURSUEO <br />10 CO^.�PLETION TH S PfR1.11i I.1nY �C CAP:CFLLED I3�' fH@ QTY UPOIJ AN1' STOFPAu� OF 1VORK ON THIS PROJECT OVER 90 DAVS UUf7ATION <br />