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Date 7i�_.�.:i�Cc / <br /> PUBLIC WORKS <br /> PERMIT PublicN'orksPermitM PWubC�-020 <br /> BuildmgPermitll $Oe.i7-OLO <br /> PUBLIC WOFlKS DEPARTMENT Planning Reference# <br /> 3200 Cedar Street <br /> Everelt.W�982J1 Public Works Feo S �`4.`ii� <br /> (4251 257�8810 <br /> Guaramee S <br /> OWNER NAM-L__ APPIICANT NAME <br /> AND ADOFESS'��F!K'T %.FiT � A:�r.:�. AN�AD�HcSS�. <br /> i7i5 cra,xo r,vE <br /> E��r;E�rr .. ..:: : <br /> PHONE: 92F'341�08 PHONE'. <br /> TAXPARCE�I.D.p PROJECTADDRGSS. <br /> pr,4;EG'440rii�Gn ' -�',;rL A�F. <br /> D[SCRIPTIONOF .,.,.. r�FT:,.^_^t'�. :_:.��r���' " <br /> PROPOSED WORK-'=�"' <br /> PERMIT CONDITIONS <br /> 1. All calls lor inspedion shall be made 24 hours in advance - phon� (425) 257-8A10 <br /> 2. All work shall be perlormed in accordance wifh this permit and current City of Everen Design and Construction <br /> Standards and Specilications. <br /> 3. Call Location Underground Service 48 hrs.belore you dig. TOLL FREE NUMBER 1-800•424•5555 <br /> W <br /> v. Crnnect �11 cooT':�F :!c.:r,spou',. . _ :he �:de �rwe: . � <br /> . hll B\CdV3i@� W3CaC1.91 fL'��m foumiau�,n, .�.l�jr_V.ilt: ;ti�l �}: : . _.:3t:; D113�:i I:�:� �13:1.9�,� 'Q '� N <br /> r,n appt�ved� pFtmi[t-rct �ite. No wasr�n:� of mate�ial i� ai::��•a<i un this riullcl�� � ,.-�t S- <br /> 6. No dirt, mud, cockc ur def;eia tc be U�acked ento Cp3dWd}'. 4�'� : _ ' m <br /> . T.o building matecials t� Le 9Y3i'42� in alley and all�y to be k�,t a�.ean �nci q�en O <br /> �,r v?hiriF teavel. - - � <br /> i� .. :'�i..__ .:-�.i': _ .,..-�_ .: �", ....._ '_;;,, i n: ,..- -- - . - , _ N i: . � <br /> � � O <br /> �1 <br /> iT �ci � <br /> .s+�n +� <br /> �. . � C �`, Yl �i <br /> TQ FuSTIiJG :� � tl �:.�� _ " � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> T ie undersigned owner;applicant hereby agrees to hold and <br /> � � . � L save harmless the City ol Everett Irom any and all claims for <br /> I n o or Co�suucuon u e damages.costs,expenses,or causes ol action that nay anse <br /> because ol installation and maintenance ol the improvement or <br /> �`_�/ \ mher right-of-way use hereto apphed for and funher a9rees to <br /> - ,�`--� ��4—rV remove same upon nolice Imm e Ciry and to replace public <br /> -INAL INSPECT pro— y damF a�t�by. <br /> Appmvea as Coi ucled Daie <br /> � �av- n�_ <br /> SignaWre ol Applican� Date <br /> 170RK AU7HORIZED[3V 7HIS PERh111 A1US7 RE S1ART[D WITHIN 180 DAVS OF DATE PERMIT IS ISSUED AN�iHEFEAFTEF 1S 70 BE DILIGEN7LV PURSUED <br /> 10 COAIPL[TION THIS PCHtdlt rdnv 6[CANC[LLED�Y T4E CITV UPON ANV STOPPAGE OF WOfiK ON THIS PROJECT OVF.R 90 DAVS�UflATION. <br />