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Application For�G P 0�T I N G Auc i � z000 <br /> � PUBLIC WORK� PERMIT �a�e�vn��'��� --- I <br /> PUBLIC WORKS DEPARTMENT Public Works Fermit M ��� � <br /> 3200 Cedru Streel <br /> Everett,WA98201 259-88Y0 <br /> Auilding Permit F <br /> TYPE OR PRINT ONLY ���� Public Works Fee$_Q7 3�S1' <br /> �:v.���✓i.� t:/if/� C�� <br /> Comm�anitv Transit, 7100 fiardeson Rd. , Everett 59203 (425)346-2367 <br /> Owner Mailing Address City Zip Phonc <br /> OTAK INC, 620 Kirkiand Way, #100 Kirkland 98033 (425) 822-9996 <br /> App!icanl Mailing Address City Zip Phone <br /> Describe Proposed Work Site work includinq pavement removal and re�acement, ■ ■ ■ � <br /> utilities, ar.d fronta� im rovements at Kasch Park maintenance fa�j]jty � <br /> �� <br /> L30C) � <br /> PROJECTADDHESS(if known) -$9�=Kasch Park Rd . _ � <br /> Attach lour(4)copies o(plans for proposed work-Draw to scale and nole Ihe following ii applicable: <br /> •Propzrty Lines •Outline anA dimensions of all existing ard proposed slmcWrea on thc lot •Existing and proposed utilities O � <br /> � 'Cenledine of street •Indicate Nerly •Show any proposed grading chanyes "Show measurements � <br /> DO NOT WRITE 9ELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1.All calis for inspect�on shall be made 24 hours in advance- phone 259-8810. I� <br /> 2. All w�rk shail be performed in accordance with this permit and current City of Everett Desiyn and � i <br /> Cunstrcction Standards and Speci(ications. V <br /> 3. Call Location Underground S��rvice 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> 7. �'JO�.�' � � � <br /> �%' O'Vs7��/^ �Ol�2i�J� ���Df�Oli��� � <br /> O/� 7- /� 9� G�/' 7/7�� �'S�.�G�iG. C�iO�C'�S � <br /> �au„�, � <br /> � ��4. � �I <br /> _:;�.., <br /> � � ACKNOWLEDGEMFNT OF CONDITIONS <br /> The undersigned ownedapplicant hereby agrees to hold and save harmless �� <br /> ` `r/ ihe Cit ol E�iered fmm an and all claims tor dama es,costs,ex <br /> �t� � �� � /" causes of action that ma anse because o(installat on anC maintenance of j <br /> Approy torConsiruction ate� �heimpmvementorotherrgh4of-wayuseheretoappliedforandfuAheragrees � <br /> to remove same upon notice from the City and to replace public proparry , <br /> _�j�C �, � 7—� —(f Q damaged the�eSy. <br /> FINAL INSPECTION Date � <br /> Approved as Censtruc:ed � -- /J-a�" 9� � <br /> � <br /> � 3tiitt—'+—.--i-�77 � <br /> ignature I Date � <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STAfiTED WITHIN 780 DAYS OF DA E PERMIT IS ISSUED AND THEREAF7ER IS TO BE DILIGENRY PURSUF.D TO ! <br /> COMPLETION.THIS PERIh�f MAY 8E CANCELLED BY THE GITV�JpON ANY STOPPAGE OF WORK�N THIS PROJECT OVEfl 90 DAYS DURATION. <br />