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PUB�ic woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everen, WA 98201 <br />`°Z"�'�rOSTING � 1 s too3 <br />OWNER NAM � �m^ T� APPLICANT NAME <br />ANDADDRES��Et�=-+1 �'l1'�OVi L..��TF_l T ANDADDRESS: <br />473ii <:ULE'i AVE <br />EVEhF.`.'T WA 9� _i;3 <br />Date .. .._,'::i.�G:: <br />Public Works Permit k r W i� � f; ;: —: j � r. <br />Building Permit a <br />Planning Relerence a <br />Public Works Fee S <br />_�: �:�.:-���= <br />;^�1�7G.05 <br />��s('►�iz � Z�k � 3�. a� <br />PHONE: 4 � 7� C E 4 7 3 O I PHONE: <br />TAX PAqCELI.D.+ PROJECTADDRESS: <br />UU4�?L,o_1p10U00 �"��`. <br />PROPOSEDWORKnEh N,hINT. L VEHIC;,E MAINT. RUZLUINi;G <br />PEP.�d1T CONDITIONS <br />AVE <br />1. All calls for inspection sha�l be made 24 hours in advance - phone (425) Z57�87iTT AVn =' RAZNiER AVc <br />2. All work shall be peAcrmed in accordance with lhis permit and current City ol Everett Design and Construction <br />Standards and Specificalions. <br />3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800-424•5555 <br />As pei appruved plan dated 4;'10/0�. <br />���. <br />,�`1 �:=� �\�, \,�, <br />�,l , . <br />�,l � <br />� ::;� `� . �nQ� <br />'•\,y \'�1• `f����. <br />.t` . . <br />,.� � ti '- , <br />ACKNOWLEDGEMENT OF CONDITIONS <br />— J�;y�V� C,('.� J/ I�/O� The undersigned owner/applicant hereby agrees to hold and <br />E ' W�-� �Y � save harmless Me Ciry of Everett trom any and all claims for <br />approvea r CanNrucMon Dai damages, crosts, ezpenses, or wuses ol action that may arise <br />��� ��� because ol installatlon and maintenance of the improvement or <br />,//:`. i�//��-� ��/ U3 other right�oFway use hereto applied for and fuMer agrees to <br />�' 1 L �� remove same upon nooce irom the Ciry and to repWce public <br />FINAL INSPECTION prope gad.tbereb <br />Approvetl as Conslmcted Dale ) Y' <br />_ — o r 7 oZ <br />SignaWre.of plicam Daie <br />WORK AUTHORIZED BV THIS PEFi�11T MUST BE STARTED WITHIN 1B0 DAVS OF DATEPERMIT 1 SS I SUED AND THEREAFTER IS TO BE DILIGENTLV PURSUED <br />TO COMPLETION. THIS PEfiM1T MAV BE CANCELLE� BY THE CITY UPON ANY 5'OPPAGE OF WORK ON 7HIS PROJECT OVER 90 OAYS DURATION. <br />`W <br />= <br />N <br />m <br />O <br />� <br />0 <br />� <br />O <br />a <br />