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PUBLIC WORKS PERMIT <br />j� City of EvereY, FuLlic Works Department <br />3200 Cedar Sireet <br />�._ r���L���� F�verett. N!A 98201 <br />�,q2�)��-_3a.1C <br />OWNER NAME AND ADDRESS: <br />BRENNY THOMAS J <br />11311 W IBBERSON DR <br />EVERETT WA 98208 <br />PHONE: <br />TAX PARCELID # 00479600002600 <br />DESCRIPTION OF PROPOSED WORK: <br />DRIVFWAY ALTERATION <br />Date 417I7015 <br />Public Works Permit # PW1504-0 i4 <br />Buildinp Permit #, <br />Planninq Reference #: <br />Pubhc Works Fee 5: 5 2590 <br />Other 5: <br />APPLICANT NAME AND ADDRESS: <br />PHONE: <br />SITE ADDRESS: 11311 W IBBERSON DR <br />PERIv11T CONDITIONS <br />1 All calls for inspection shall be made 24 hours in advance. <br />2 All work shall be performed in accordance with the permit and current Gty ot Everett Design and ConsVuct�on Standards <br />and Speciflcations. <br />3 Call Localion Underground Service 48 hrs before you dig TOLL FREE NUMBER 811 � <br />4 Per approved plan dated 4/7/2015 <br />Your Public Works Inspector �s Chff Lindman Cail 425-339-7404 for any questions andlor inspechons � <br />Cr 1 � _, <br />Construction <br />INSPECTION Date <br />ved as Constructed <br />� /� <br />2/ -/ <br />AG'�CP!OWLtDGLr�t[NI O� CUtdD�i�ONS <br />The undeis�qned ownerlapphcanl hereby agrees to ho�d a��d <br />savc narmless ihe Clty ot FvereU from any and ell dain��s 'c� <br />damages, cosis, ezpenses, or causes o( ac6on Ihal m�ry .n �.�� <br />because of installauon and maintenance of ihe improver�i�t <br />or other nght-of-way use hereto applied for and lur7her acrec; <br />to remove same upon noLce from the City and to repiace <br />public pioperty damaged thereby. /� <br />� y/�/IS <br />Signa� reotApplicanl Date <br />�VORK AUI HORIZED BY THIS PERh11T P1UST �[ ST�RTED WITHIN 180 DAYS OF DAT[ PEFMIT IS ISSUED AND THER[AFTER IS TO 6E �ILIGENTIY <br />PURSU:=L TO COf4Pl [TIOPI THIS PERhIR id�Y C>L' UN.CELLfD �Y THG CITY UPOIJ ANY Si'OPPl�6E OF CJOR%O�J THIS PROJECf OVER 9U DAYS DUfiATIOL. <br />I� <br />