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PI��LlC WORKS � <br />PEi�IVI1T <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />tT ��ozsnzs� szos � � � S 2-�� <br />_. _• �) 1,—•, r, .�'� <br />�� � ��oi��� � ���iti....i�PR ............. . <br />owNea Nn�r[ gp,NSON J.iLL <br />PNDADDRFSS: <br />3202 LAUF�.r`.L l.�F. <br />EVEP,ETT G1A <br />rHONE: 9253�9116�] <br />7AXPARCELI.D.0 f���lr�l'��Ic�]L�4O <br />n�scairnov or _ . n`-' r'- <br />PROPOSfD NORK. <br />nr_nl <br />APPLICANT NAlAE <br />ANDAD�RESS <br />PHONG <br />Date <br />-, ;��;_�,,,�, <br />PublicWoMSPcrmita F4J05�7�-�l;? <br />, �;_, = � <br />Building Permit M <br />Planning Reference n <br />Puhlic Works Fee 5 _.:5 . n �) <br />Guarantec 5 <br />Pao.iectnooness�. : `._�i � �rfF:EL C:�; <br />PERMITCONGiTIONS �<'TS 1, _ .� , iE�` �_ ^ �1 �i;i' <br />Ti?r."rr�'.z :�'iu L,-'- . . �, .iL�_."'." _. <br />1. All calls lor in=pecl'on shall be made 24 hours in advance - phone (425) 257-84�'I0�'=�� ��t�`` ADGii_�'��:i <br />2. All worie shall 6e pf�rformed in accordance w�th this permit and curreN Cily of Everett Design and Constructi�n <br />Slandards and Spaci(ications. <br />3. Call Location UnJerground Service 48 hrs. belore you dig. TOLL FREE NUMBER t-800•424-5555 <br />d. Cnnnect eo�,gtep do•�:n�p,-•uL. �o �•• �a.vn �n a-,�c.p v-_.- ..�de ee�„m�c <br />. t•taet vith Publi: works Inapu.,toc iRirk, 4��•-,39_79(,si ncioc t_� installin:_I driv�s�,:� <br />.-. Connect side �euec pe� City a^tandacdE r?601, 0"02, r;09 <br />".. Uamuli�h c3rpoct on th� n�>��th �l�:le uf the lot t�efoce b�ginning construction �� <br />... . . t._,_ ,_.,_ ; . <br />. .,:s.�.� �-cr., _�-. . <br />_ `I i . r`� rri r- - <br />o-i �-� � � e_: � . <br />' i � r � T �.."'� <br />.-� J „'J '�� <br />'� . <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Z <br />O <br />� <br />O <br />� <br />The undeisigned owner/applicant hereby agrees to hold antl <br />save harmless the Ciry ol Everett from any and all tlaims fw <br />damayes, cosis, ezpenses, or causes of aclion ihat may arise <br />becau e of installation and maintenance ol ihe improvement or <br />othor ght�obway use hereto applied lor anC lurther agrees to <br />rem ve same upon notice Irom the City and to replace public <br />pro qF1y danta/("�e hcreby. c-, <br />'(,�2(_Y �"��,ut'L �'.Z� J� <br />SignaWre ol Appl' an Date <br />1:i.iFH AUTMORIZED �V THIS PERt.11T PdUST [lE STMTED WITHIN 1�0 DAYS OF DATE PEFMIT IS ISSUED AND THEflEAPTEH IS TO OE DIUGENTLV PURSU'cD <br />Ii) (.UrdPLFTION THIS P[fib11T 6!AY 13[ CANGELI.ED �V THE QTl' UPON AIJV `TOPPAG[ OF" .K ON THIS PROJECT OVER 90 DAYS DUflATION <br />