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� <br /> PUBLIC WORKS Da�e 1=;O1;20D3 <br /> � <br /> Public Works Permit a pi70312-001 <br /> PERMIT � ' <br /> Building Permit!1 <br /> Eo=u9 u,' <br /> PUBLIC WORKS DEPARTMENT Planning Reference a <br /> a200 Cedar Street <br /> Everett.WA 98201 Public Works Fee 5 �q�l ,00 <br /> (425)257�8810 Guarantcc 5 ' <br /> OWN[FiNAME LIE GUttNAF. d LIE APP��CANTNAME ATCT WIRELESS <br /> ANDADDRESS: ANDADDRESS: <br /> Q309 OLYMYIC VIE41 Dk <br /> EDMO}In5 UA 98D�0 <br /> ,�E; PHONE: <br /> TA%PARCELI.D.p �8090200300300 PROJECTA�DRESS: �71r� r1EF,gILL CF.EE2i PFWY <br /> �ESCRIPTIONOF ANTENNA fi EQVIPI•�NT <br /> PROPOSED WORK: <br /> ATfiT <br /> PERMIT CONDITIONS <br /> 1. All calls lor inspeclion shall be made 24 hours in advance-phone (425) 257•8810 <br /> 2. All work shall be performed in accordance with this permit and current Cily ol Everett Design and Construction <br /> Standards and Specilications. <br /> 3. Call Localion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 � <br /> � <br /> 9. Fec sppcoved plsn. � <br /> t.�.����d �g�(rel � <br /> j� Lri,�dvrkl�� ��-e, �x ; s�ti,� 5,,.� I�e. -� z w � <br /> new �7 l�.n L�N� s ���r c i� 5{�„cror d j �3 - ',�Fro1-Oa �3!�J?PrrstZ��, oS� Q <br /> d 309033 � <br /> �C Z,-��.t�G�u2�• RUILCi 644.25 <br /> SRCHG 4.50 Z <br /> tl 31�001 O <br /> PW/RUW 20.00 <br /> PWlIN51' 20.Ofi � <br /> -FO7'AL 688.75 <br /> Ckii=K: 68� <br /> A OH`559 <br /> a <br /> ./ <br /> ACKNOWLEDGEMENT OF CONDI710NS <br /> p' i � �� OZ The undersigneA ownerlapplicant hereby agiees to hold and <br /> / �y� ' ) save harmless tho Ciry of Everett fmm any and all claims lor <br /> C,�o%. �- <br /> qpp'mvee rConsi c�ion. Da�e damages,costs,expenses,or causes ol action Ihal may arise <br /> becauso of installation and mainlenance ol the improvement or <br /> �,!��� � _��_ � olhar righl�obway use hereto applied lor and lurthcr agrecs�o <br /> ' U remove same upon notice Irom the City and to replace public <br /> V <br /> FINAL INSPECTION property.d aged thereby. <br /> Approvetl as ConSImcIM Data ��C��� , f 2-� •-�';3 <br /> _J <br /> Signature ol Applicanl D��e <br /> WORK AUTHOFiIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED <br /> TO COMPLETION.THIS PERMIT MAY BE CANCELLED BY 7HE CIN UPON ANY STOPPAGE OF WORN ON THIS PROJECT OVER 90 DAYS DUPATION. <br />