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PUB��c woRKs <br />PERMIT <br />PU�IIC WORKS DEPARTMENT <br />3200 CeAar Sireet <br />Everetl, WA 98201 <br />(425) 257-8010 <br />1WNERNAME �`�-�71Qd11 H1QC1��? <br />�NDADDRESS:,��i � G��i,a�,t <br />EVEkETT hi, C. <br />PHONE: 4 ,i �i .i'i _i 7 ,� � � <br />TAXPARCELI.D.M <br />DESCRIPTIONOF t'�-it" -,..,:!-i:.tl �.-',7. _' . _�.Ly <br />PROPOSED WORK: <br />APPLICANT NAME <br />ANDADDRE55: <br />PNONE: <br />Date - :��i�; <br />�j.., <br />Public Works Pertnit N pW0�05—G 1: <br />Buildiny Permi� p <br />Planning Reference N <br />Public Works Fec S �''��� �� <br />Guarantec S <br />ADDRESS: a�i 1 i li: �_ ' 1`( <br />PERMIT CO�'DITIONS <br />1. All calls for inspection shall be made 24 hours in advance • phone (425) 257-8810 <br />2. All work shall be periormed in accordance with Ihis permil and current City of Everett Design and Construclion <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. belore you dig. TOLL FHEF NUMBER 1-800-424•5555 <br />4. Ti�rtir_.in�• :ici.,,w.:�y c>>�:ofC t.r, ,_:,:i�.�t_ing ��ii :,it„ iri_iltra'..o�i �.y.:.._.,, <br />�.. F,�, � _ ..t.-�:,rt�-: r]i��i7: � � ..- t ]7-o;s � <br />' 1- � ' � - � i _ _ Uilt�] L�� C<41:'..:.I UC1:lUL. <br />0� 0� 02 2:48F" <br />�I 208011 <br />'�F:VE �S.OG <br />�-U f A.. :'S.00 <br />C HE�: <br />a o���o�� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />/ <br />The undersigned owner/applicant hereby agrees to hdd and <br />savc harmless Ue Ciry ot Everetl irom any and all daims fa <br />damages, costs, expenses, or causes of action that may arise <br />because ol insWllation end maintenance of the imprrnement or <br />other right�ol-way usa hereto applied tor and fuMer egreas to <br />remove me upon notic irom the City and ro replace public <br />propc d ag t e y. <br />G � . � -a -v�. <br />Signature of Applkanl Date <br />WOHK AUTHOR12E� �Y THIS PERMIT MUST BE STARTED WITHIN I80 DAYS OF DATE PERMIT IS ISSUED ANO THEREAFTER IS TO BE DILIGENTLY PURSUED <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLED BV THE CIiY UPON ANV STOPPAGE OF WORK ON 7HIS PR0.IECT OVER 90 DAYS DURATON. <br />