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/ � <br /> PUBLIC WORKS Datc . i .. <br /> PublicWorksPermita :'19;.���iq -ilU? <br /> PE R M 1 T Building Pcrmit M <br /> PUBLIC WORKS DEPAFTdENT Planning Reference a <br /> 3200 Cedar Street . ' <br /> Evcrett,WA 9820t $EP 1 8 2003 Public Works fee S � - � ' �' �� � �'�� � <br /> �azs1��U ���������� ��� <br /> � ��—. Guarantee S <br /> , <br /> O�YNER NAh1F ' 1 � �� . { 4 APPUCANi NAME '� <br /> ANDADDRFSS' ' `�Y��1�� - �' ' � i � - � ' ' r -qNDADDRESS: q <br /> �:; Ro;: _ . � <br /> I <br /> L v.,: �_• ...- ' <br /> � <br /> FMONE -}�_�_;•;?4 �+ . ' PHONE: ( <br /> TA%PARCELI.D.� PFOJECiADDRE55: � <br /> ,�,� . ;�':'..��t <br /> DESCRIPTIONOF ;;j;;,• ;�,i :iit; ti'.,'! <br /> PROPOSED WORK: � � � � �- -' � i� <br /> . .. I <br /> � <br /> I <br /> PERMIT CONDITtONS I <br /> 1. All calts lor inspection shall be made 24 hours in advance• phone (425)257•8810 ; <br /> 2. All work shall be pedormed in accordance with this permit and current City of Everett Design and Construction i <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FHEE NUMBER 7-800-424•5555 � <br /> � � �_ ��� _ �, t . . , . , � . , . � <br /> � .,�.iu�� �� 11.g cu. : �,' . t _;_t; t. � � , t�_.i�_ �i �. ,�„ii� 1 : _ � wt�t�_ i.� , � <br /> • �viPwed as a part of this puLlic wnr,c, pecmit, huwever Y: � _ . . •A <br /> _ ' all� , a,. ��. : � � '. t . - _ ! � _ _ . f F.�,�_ �_' t Fl iti::� n�� V/ <br /> ,. ` W <br /> 04-04-02 1�•OBFM O <br /> A 2Q4007 ' <br /> OTHER 45.00 <br /> PW/RVN 1185.00 � r <br /> F'll/TNSF 2371.00 O I <br /> T07AL 360]..00 <br /> CHEF: 360�1tl <br /> A OM7371 � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITION.", <br /> D The undcrsigned owner/applicont hereby agrecs b hold and <br /> �(�(� 3 Z save harmless Ihe City ol Evcretl trom any and all claims br <br /> a�ro+ed lor ,dnstmr,t . Date damages,cosis,ezpenses,or causes of action thal may arise <br /> i , because ol installation and mainten�nce ol�he improvement or <br /> other right-obwa;use hereto applied lor and lurther agrces to <br /> , � 4�� -%� �� �-V 3 remove sa':�u u notice from the City and to replace pcblic <br /> FINAL INSPECTION pmpe dam ed Ihereby.��� <br /> AnP«���as Constmc�etl Dale � D� I <br /> 1 <br /> Siq Wre ol A�i� Dale <br /> WOPK AUlHORIZED BV THIS PERMIT MUFi BE STARTEJ WITHIN 180 DAYS OF DATE PERMI7IS ISSUED hND THEREAFfER IS TO DE DILIGENTLV PURSUEO <br /> � TO COMPLCT!CtJ TWS PERMIT MAY OE CANCELL[D�V TH[CI7V UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAVS DURATION. <br />