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PUBLIC WORKS <br />� PERMIi <br />PUOIIC WORKS D[PARTMENT <br />320� Cetlar Strect <br />[vmett, WA98201 <br />�nzs� zs��eaio JAN 0 3 2006 <br />T� Pp$TpN�= -- <br />OYJNERNAh1E �,OAIF ENTEF:PF.I:;ES LL�= ANDAO <br />ANDADORESS 1�U3� '?5TH A\'E SE <br />P.i,THELi WA 9cL'�1:. <br />PHONE' A�SZa31�1� PHON[ <br />TA%PARCELI.D.a O(��� �F.+ii(11(�7']ll PROJEI <br />DESCRIPiIONOF . .�.��" --~�"�- 1.., <br />PROPOSED WORK. <br />PERMIT CONDITIONS <br />r rinn�e <br />Date <br />r.'' �C41:Qng <br />Public Works Pertnit a c;��50b-U47 <br />caso�-o=� <br />Building Permit a <br />Planning Re�erencc 7 <br />Public Works Fcc 5 __; .�� �� <br />GuaraMec S <br />�ODRESS ,Li�L t;--••� <br />E... ..i�_:'�.1iG pF. <br />:,�:�T y c'= :�xc�r�.T F�.aT _.�:o�—��=���—;�=s <br />i. All calls for inspection shall be made 24 hours in advance - phone (a25) 257-8810 <br />?. NI work shall be performed in accordance wilh this permit and current City of Everell Design and Construction <br />Siandards and Specilications. <br />3. Call Localion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />7, r_ennect CJOICOi' �jGLlI1t3U0UC:; _C r�lr_ �jCillld�j�`_ :)/:CEI� �?YU4'l�j�?�� I�L L�ll� lOt. <br />. Install ecosion ..ontrol mea�ux�s per City of Evciztt 5tsn<lacds ioc small F�aic-•_s <br />b.R@NOVN "COS10R COfItL'OL N�d9UL'Eu U�i011 completien Ot th? (?tJ]FCC �)C1QC t0 iltl_�L <br />_���proval of the pennit <br />;. A sF�rinF:ler syst�m is cequired fr�, this buildima in compliance af+n cti� <br />,,�:,7i ,c.in��nt-�: �=i hTGr., S*�mi.an:s 77[- - _ .� �- " -- - . <br />c.. - <br />_ �-._ IT` -� � S' <br />r � -. <br />G <br />i" <br />1..: <br />1 �r, <br />. C'�1 <br />-�,/�,�':, 7 7 s <br />wmA Ini Con,lrurlion aie <br />i�% — �� `� <br />, AL INSPECTION ��N 1 <br />�I �r.p�ovMasCons�mded D�tc <br />;: r, w <br />�..— !-- <br />�. r <br />N.� ..� .� u. <br />. `P N n� �,i .n IP �-- <br />� _.�].a+O.�li�r_ <br />ACKNOVdLEDGEh4ENT OF CONDITIONS <br />W <br />F- <br />�r^ <br />V/ <br />W <br />O <br />� <br />The undersigned ownedap{.�icant here6y agrces to hold and <br />save harmless the Ciry of Everett Irom any and ail claims for <br />damages, costs, expenses, or causes ol action that may arise <br />beCause ol insWllalion and maiMenance ol ihe impwvement or <br />other right-of-way use herelo applicd for and luriher agrees ;? <br />remove same upon notice Irom the City and to replace public <br />properry damaged thereby. <br />_r,,:.,,yi.__c�-V�Y.` L. ",�,�- ( U�J <br />3� Date <br />ISiqnalure I Applwanl <br />i__ <br />�CWOPK AUTHOf�iZCD 81' l i r7 PLliq9i I.tU'ST f1F S7nRTFD AVRHIN tP0 DAYS OF DATF PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLV PURSUE <br />TOCO�dPLfll:i;: Tlur.I�I���'!.�I r.'%�� PI: f,n^10Eu.tUPVTH[(:ITVUP�NAl.VSTOPPAGLOFY�OPKONTHISPROJECTOVERM7DAYS�URATION. <br />