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' - 'i <br /> Date �1 t��� . .'�",.. <br /> PUBLIC WORKS PublicWorksPermit8 F'�'(�r��� _ <br /> PERMIT 8�,��d��9P��m,�# �-� ,�, : , <br /> PUBIIC INORKS OEPARTMENT Planning Relorence# <br /> 3200 Cedar Stmel <br /> Evere��,WA 98201 Public Works Feo 5 <br /> (42E)257-8870 - � <br /> uaranlee S <br /> --T��QSTI(���;u�t2 . <br /> __ _ ___ -- -- - ��— <br /> I C\NNERNAI,IE � ANDADDRESS: � <br /> � AND AD�RESS' � . , !.CtEP.i T 1i�' !+.�L�.�: <br /> � . . _.. :�..?cL' A.VE N4J !!('-S c^i�f_'.� �' . <br /> I� 7':�.fIW06G WA 9;<�;•.� <br /> I P„or,E: 3�n:.�+a0960 PHONE: <br /> iTAXPAFCELI.DN — PROJECTAODRESS: <br /> IlQ�Q1](��I11(�Qh:�.Q� 'JI . ...I.'.4`,��'r_ �-: - <br /> IDESCRIPTIONOF �„^4 P��If_Su�" -� i�' �'� ' <br /> PqOPOSED WORK: ..� 1 . T-�?.�. . - . <br /> � <br /> �_--- —__ —_— __ <br /> PERMITCONDITIONS '�'-'�'������� �- � '�' �� -� � ' <br /> t. All calls for inspection shall be made 24 hours in advance. <br /> 2. All work shall be perlormed in accordance with ihis permil and currenl City ol Evere�� Design and ConsUuction <br /> Standards Gnd Specihcations. � <br /> 3. Call Location Underground Service 48 hrs.before you dig. TOLL FREE NUMBER 1-800-424-5555 ` <br /> r <br /> ��/� <br /> . ' �. . . . _.. .. . .,,.. . . .. , . . .. . -.. V� <br /> � .r._ct .. �ft�;p •9� c.ne;p��ut t tn<.• i_aic:�g� 3�..�__, �«vi�:i_•� foe thia i��: . :� - ' <br /> nvtall ecosion control me�sucea a� determined Dy the Pub7ic'Yloik3" in�pLttax� s��•-� � <br /> iit fence, atrav bales, svale�, or etrosien b73RkCt9.^�—���' �-- ���� O <br /> ..r.�r; �' 'l^i�rTt tj <br /> : � dirt, mud, ccx:ks oe debris to be tcacked ento roadvay.�,'�j ����'� � <br /> , buildinq naterials to be ata�ked on aidaura2ks and S1CIV�ST[9 to be kept cl�n ac:.: ' <br /> tor. i�edestrian tcave3 . � ,�_ _ <br /> � . r-� � <br /> , . .. _ . _ . . . . . . - � _ . '_. � O <br /> .� w r-,y�- . � <br /> ����� � Y/ <br /> �� ��c`�+c',��Fi-_�_ u�'�i <br /> � - �. . -. � ' � . O <br /> a <br /> i ---�-- �-� -�- "�- --- -- - � �- � - ArKNOWLEDGEMENTOFCONDITIONS <br /> I � / ,-• � The undersigned ownedapplicanl hereby agrees to hold and <br /> I %t <br /> -_�l�'� , , O save harmless the City ol Everett Iwm any and all claims for <br /> _�/ �� �-'`�nr s � � �U /L J damages,cosis,oapenses.or causes of ac�ion Ihat may arise <br /> Appr ed lor Constmction ate because ol inst211ation and rrlaintenance of the improvemenl or <br /> other ngh4ol-vray use Itereto ap�letl lor and Iurlher agrees to <br /> ._ - � � -- - - �� remove sametipon nWice Irom he City and lo replace public <br /> FINACINS"ErTION� property�damaged ihereby;�� <br /> ApProveu ao Consiruc�ed — -- _ Oale — � - � <br /> � <br /> � . _ , : - ' , _ . , � <br /> Sig�at�teDrApplir,anr � Date, <br /> WOPK AUTH�)RIZEU BY THIS PERMIT IdUST 13E STARTE�WITHIN 1B0 DAYS OF DATE PERIdIT IS ISSUEDANO THEREAFTER IS TO BE DIUGENTLV PURSUED <br /> TO COMPLE ION.THIS PERMIT MAV O[CANCELLED 6V THE CIN UPON ANV SIOPPAGE Of WORK ON THIS PROJECT OVER 90 DAVS DUR.4TION. <br /> [PWP p:Gr� �ATApAN.INQ <br />