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^ � Date <br /> P���IVi�WORKS ,;(;.I . � :)`';_".; PubLcWnrksPermitA <br /> RIEIRMIT _� o��{� ^ <br /> CT 1 Builtling F^rmit n . <br /> PUBLIC WORKSDEPAf,iT�i1��T{�� pl�nning Pelerence k <br /> 3200 Cedar Slreel� <br /> Evcrelt,W{�98201 �c Public Korks Fee S <br /> f4251257•B8t0'- gQf','a-' . <br /> i.��,i�l, t��QJ)..� GuaranteeS Tq�7`!C.- r'�)�l CD <br /> ;i i� yF�,«� <br /> OWNEfiNAME f. ;',il;j{ APPLICANTN EiJil � <br /> ANDADDRESSI � �- � -� �"- - � � ANDAODRE��+�� <br /> � �i r�ii+.� °`'�•�' jQ �nSj�NG AUG 20 2008 <br /> � - -� � - 1 , GRIVE 4�.;:� <br /> -- - � G70';p13 ---- <br /> rr+oNe: 1 I+LDG. rHONe: 5:,�;.W <br /> � �'-.��— <br /> TA%PARCELI.D.a I " PRQIEC7A ,..f�`S� ��� ^ <br /> JlVI'7 O <br /> DESCRIPTIONOF ��Q ` ��••11� <br /> PROPOSED WORK: � � 5r5 ���; 5��.�p1 <br /> 1 l�'AiEF �1�4�.�� <br /> h 07�7��9 <br /> = �_;:�"r' S1�.t�) <br /> ,�"'i�` <br /> PERMIT CONDITIONS '�i: `1�. :";i:(�:1 <br /> i_ :&i',.'_�.%1 _'l0 <br /> 1. All calls for in;pection shall b^made 24 hours Inativance. :"�.=,��1 �N! <br /> 2. All work shall be pedormed in acwrdance with ihis permit and wrrent�ity or Everett Design and Conslruction <br /> Standards and Spccifications. � <br /> 3. Call Location Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800-024-5555 ` <br /> 1�' <br /> ,�A <br /> � _. , . _... __ ._ -_ . <br /> V+ <br /> �'C�I7hCdCtpC fLUHt RIE^?L WLI}i tilE i'UUZIC LQC�R 171`t�'��' � � <br /> . '�.:• ro'�ttin7 j�ci��r ro k�:K;innin.� the ptt�jc-ri . O <br /> ?�1 =L��91ng ?nCLLO� L.?39UC@5 =_s �.i�taL�in��i hy rh� FuLl�c +t,,eE_s 1l13F•:•r. <br /> c fencc, stLav bale<„ sti+ale+�, oc 2l'OS1U0 t�l.�nkets. ' <br /> ��Vo ?tn,jntl rnI7CLn1 n«.a�uee� up�7n COID]?Z?i7Pi1 Of the grojp-t �[1�C i0 ` <br /> . __ pf `!3P �-?CII�1L. � <br /> 3ict, raud� C��'�:S G!' �1?bc.s to ba tcack?�9 -•. O <br /> � t.u±]din�i n��t�rials tn be 3fFCl:<'CI cm road�: <br /> r n.�destrtin tzavel. � <br /> ;U.".I: �.:3C41' Cf2221 hn•r, i•• 3��OP? .".l�E'Vylj: �7L:� � <br /> :�:vs and c�'F�1ac� ,-ucb, gu`*ee in�i sid<_ualk N <br /> =R � z06 on thas proF-t�syl's frnntayF .9s d; : .. O <br /> =17 ,.+nuaed ��civeway.^. and an� br;:�k.�:i �!• oahaye�i area �;.::: t�= ce�_�:.a /� <br /> ,r�,�eway 2rn�n r_h? #z_�r.t psnF,c_.c:y line eut tc ._ _tt-:., r r,c , `i <br /> :-�r�z pump �y;t�m i� t„ h�a insr.slie•i, ti�e � : <br /> h-1:.� then g[aYit}' fl<�w• ;rt �..., `h. ���:t�i� <br /> - ACKNOWLEDGEMENT OF CONDITIONS <br /> , Tho undersigned owner/applicant hereby agrees to hold and <br /> ! O save harmless the City of Everett Irom any and all claims lor <br /> � damages,costs,expenses,or causes ol action Ihal may arise <br /> I o� r Construcuon ate becaus=of installation and ma�ntenance of the impwvement or <br /> /�� �-.yn other right•ol•way use hereto applied tor and lurther agrees lo <br /> � ,�o�—�% -� C[:�` 7'� ,�-O remove samo upon notice Imm Ihe City and to replace public <br /> FINALINSP ION pfOpert tla d�hOr by. <br /> Approved as Consiructed Data <br /> ' � �i� ��/ZS/� <br /> __ Signatu IAppIKanl Oato <br /> CJOPK AUTHORIZED BY THIS PERfd1T I.IUST DE STARTED WITHIN 180 DAYS OF DAIE PERMIT IS ISSUEDAND 7HEREAFTER IS TO BE DIUGEN7LV PURSUED <br /> TO C01dPLE710N.THIS PER�dIT IdAY BE CANCELLED 8V THE CITv UPON PNY S70PPAGE OF WORK ON THIS PROJECT OVER 90 DAVS DURATION. <br /> i,:.:,n�r a�,i oa�nen,�Nc. <br />