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rn va� I�t'L��;ii� <br />Pus�ic woRKs <br />PERMIT � <br />PUBLIC WORKS DEPARTMENT <br />3200 Ceder Streel <br />Everetl, WA98201 <br />(4251257•8870 <br />�,..n�� �..,m� - r - <br />ANDADDRESS: ' - -� � � � � �• � <br />PHONE: „"' ' . <br />TAX PARCEL I.D.1 ; � '� . .. . . - <br />DESCRIPTIONOF - ' <br />PROPOSED WORK: �'-- - - . . . . <br />�1�;� �a� <br />PERM! i '.ONDITIONS <br />^f:"y <br />Pf10.lECfADORESS: , : <br />�, , � <br />Dale - • � � " ' <br />Public Works PermN M u�..1 r 1�i .- <br />BuiWing Pertnfl X <br />Planning Reference M <br />pudic works Fee E <br />Guarantee S <br />,:,_ :� <br />_. _ _ -_,�_ __..-., - <br />t. All calis for inspection shall be made 24 hours in advance. <br />2. All v:ork shall be peAormed in accardence with this pertnit and current Ciry of Everett Design and Gonstruction <br />Standards snd Specificatlons. <br />3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800-424-5555 <br />... . ..:_. : z.. . . . <br />. ; _ � �''.,- .,-,�., ,:; =� �::, <br />n: _•.nte_:t. +_ ,m�. :r -- - =i, <br />n-��7e rauting pri�r t�; beginning tiie p�o]z'-'• _ - -.. <br />- Pt;,ll �-1n<inn cortcol mea::uLe� per ri'.y of Ev�.r�,te .�.:no:n-i_ fur s�;;:,] rarc• <br />- �'�:, d1L'rr �LL�� Li�:�9 GL l�"_IiL'�� T.,:• �.,= 4C3i:}:Aj ^R�J T�t_ ' aj _.., ". <br />= drivewsy ftea, the fc_�nt Frcp_•e?S' lir.e ou2 t�.� .h� . in-. r'r�in�. <br />, _... -_ ,cr.:i Tt:�J, r"-i. _?c: ,+m �_�_-��an_�Q•i., <br />_ _ . t.i . _: .._. : . ._. <br />v � / � <br />proved lor Conslruction D o <br />AS l�.OfISINCICU D8I0 <br />, <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownerlapplicent hereby eqrees lo hold and <br />save hartnless the Ciry of Everett from eny and all claims lor <br />damages. costs, expenses, or causes ot actbn thet mey arise <br />because ol fnstallatbn eM melnlenence of 1he improvement or <br />other rightof•way usa hereto applied tor a tl i ure eae�9�b ic <br />remove seme upon �otke trwn �nY P � <br />p rry dameged r9D1t � <br />---- ) - -�=—�L� <br />Signawre ol Dete <br />TO COMPLETION ETH SVPERM 7EMAV �E CANCELLED DV�T E CI V��ON ANV� S�OPPAGE OF WORK ON TH�S R0.1EC OVER 90 DAYSIWM��PUFSUED <br />wr�w. u+a <br />EPWPI]rtlfil <br />