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PUBLIC WORKS
<br />PERMIT
<br />PUBLIC WORKS DEPARTI.IEIJT
<br />3200 Cedar Stwet
<br />Everctt. WA 98201
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<br />DESCRIPTIONOF •- � �-� ��--
<br />PfiOPOSED WOtiK�.
<br />PERMIT CONDITIONS
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<br />Public Worhs Permd r � �• - � � � -
<br />Bwlding Permn n
<br />Plannmg Rclerencc n
<br />Publlc Works Fec 5
<br />Guarantec S
<br />APPLICANiNAh1E; t\:.';.. _. �i(�t:A'��E:�
<br />ANDADDPE55 .
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<br />PROJECTADDRESS.
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<br />1. All calls for inspeclion shall be made 24 hours in advancc - p1'.one (425) 257-8810
<br />2. All work shall be performed in dccordance w��th ihis permit and current C�ty ol Fveretl Design and Construciion
<br />Standards and Specilications.
<br />3. Call Location Underground Service 48 hrs. be(ore you dig. TOLL FREE NUMBER 1-800-424•5555
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<br />�,__. ,�� _in- �,t,�i,r,:iy _in��,
<br />_. �.'ontiect saiiicary �ewer p��t city uf evere�t standatd o01, 6C_..
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<br />� `.-�11 an infiltration eystem 2�a� ,: ;' �,� _ . .:: �c,l�� ,�� -�,�1�,., i
<br />i u f I from t oof top dowri_7,nut ._
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<br />`� FUILD 678.75
<br />f r'rc�.� icNY 5. � S/ >�i `' ` SRCHG 4.50
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<br />np,^,inve� br Consbuclion Date
<br />f=1N�L INSPECTION
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<br />LIRIVE
<br />MECH
<br />FLUMB
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<br />SEWEF
<br />UTILITY
<br />WATER
<br />TOl'AL
<br />GS.00
<br />60.00
<br />28.00
<br />�O�Q15
<br />70.00
<br />1101.00
<br />800.00
<br />�767.25
<br />A OM6750
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<br />CHEh` 2767.�5
<br />ACKNOWLEDGEMENT OF CONDITIONS
<br />The under��gned awner,'applicant hereby agrees lo hold anU
<br />save harm. ;s Uie Ciry ol Evcrett Irom any and all claims for
<br />damages, c osts, expenses. or causes ol action that may arise
<br />because ol instaltation and maiNenance ol Ihe improvement or
<br />other right-ol-way use hcreto applied �or nnd lunher agrees to
<br />rrmove same upon notice trom the City and to replace public
<br />property tlamaged Ihereby.
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<br />SignaWio ul Appbcani Dnte
<br />\VOHN AUTHOPI7f'U F3V THIS PEPM1UT M1tUST C1E 3TARiE1� PJIIHIN iP0 DAYS OF DATE PEFMIT IS ISSU[� AND THFPEAFT[R IS TO 6[ DILIGLNTLY PURSUED
<br />IU f.OMPLGTION THIS PGHh11T 1,'PY fiG CANCELLfD B1' IHE CIIY UPON AVY STOPPAGE OF \YORK ON THIS PROJEC7 OVEF 90 DAYS DUflATION. ��,
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