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I�UBL1�. WORK� ie <br /> PubliC Works Permit C <br /> PE R M 1 T Building Permit# <br /> FUBLIC WORKS DEPARTM�NT Planning Reference= <br /> 3200 Cedar Sireei aublic Works Fae 5 <br /> � Everel�,WA 98201 <br /> �425)257-8Bt0 Guarantee 5 <br /> 047NER NAME - � ;., , �PPLICANT NAt.1E <br /> ANO ADDRESS�.;.. '•: ' ' .. . AN���L7DR[SS <br /> PHONE' . � . � PHOIdF. <br /> fAX PARCFi I.� a � PPO.IECT ADOH�SS� � � <br /> OESCRIPTION OF <br /> PROPOSG�WORK: <br /> PERMIT COND:TIONS <br /> �. All calls for inspectinn ahall be mdde 24 hours in advance - phorie (425) 257-8810 <br /> 2. All worh shall be pertor;ned in accordance with this permit and current City of Everett Design and Conscructi�n <br /> Star.dards and Speci(ications. <br /> 3. ('all Location Underground Service 48 hrs.before you dig. TOLL FREE NUMBER 1-800-424-5555 <br /> �� <br /> �� <br /> .�^ <br /> G'/ <br /> W <br /> O <br /> � <br /> Z <br /> O <br /> H <br /> � <br /> Q <br /> � a <br /> � , (.Y S o <br /> ��Cy '�S I � '� S �C� � � ��ACKNOWLEDGEMENTOFCONDITIONS <br /> I - � / � � The imdersigned otivnedapplicant hereby agrees to hold and <br /> :'; , '; . ._ �' � � i save harmless the City ol Everett from any and all claims for <br /> Appwved for Conslruaio Date damages,msis.expenses,or causes of action ihat may 2rise <br /> because of installation and maintenance of ihe improvement or <br /> - olher right-o6way use herelo applied lor and luriher ayrees to <br /> remove same upon notice irom ihe City and to replace public <br /> FINAL INSPECTION proper�y damaged ihereby. <br /> Appmvetl as:onslmcled Da�e -., - J�-, <br /> --:-�L� i- <br /> SignaNre 61 Ap{IliCdnl j Ddle <br /> � <br /> / <br /> y;Oq1:AUI IIORI7[D RY THIS PFRFdiT 1.1U5T C[STARTED WIiHIH t8�DAY3 OF�ATE FERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLV PUflSUEJ <br /> l0 COI;.PLI`I I��N I1115 P[ilL11I 1.1AV[3E CAIdCeLLEU 6V TH:CI i V UPOP!ANV STOPPAGE OP WOR✓.ON THIS PROJECT OVER 90�AVS DURATION. <br />