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Pus�ic woRKs <br />PERMIT <br />PUBLIC WORKS DLPARTMENT <br />3200 Cetlar Street <br />Everett. WA 9B201 <br />(425) 257-eeto <br />OWNEfi NAME APP <br />ANDADDRESS�. JOPE Skeel� AND <br />10202 Montana Rd <br />EVERETT oA ?82U4 <br />PHONE Q25514�637 <br />TnX PARCELI.O.a <br />PHONE <br />PROJE(:T <br />NAM11G <br />Date <br />9/30/2003 / <br />Public Waks Permit a py0309-031 <br />Building Permil a <br />Planning Relerence b <br />Public Works Fee 5 <br />Guarantee $ <br />DESCRIPTION OF <br />AROPOSE� W�RK Fill in back yaed acea tn leval out - appx 1�)Dyed� <br />PERMIT COND�TIONS <br />1. All calls lor inspection shall be made 24 hours in advance - phone (425) 257-0610 <br />2. All work shall be pertormed in accordance wdh Ih�s permil and current City al Everetl Des�gn and Conslruction <br />Slandards and Specilicaiions. <br />3. Call Location Underground Service 48 hrs. before you d�g. TOLL FREE NUMBER 1-800•424-5555 <br />522.50 <br />9. ICeep city streets clean st all times during construct.ic�n. <br />5. Peovide ecosi��n conteol at dicected by the public w�ek:: in,pertoe. <br />6. All chunks of evbble (Y9CA� COlIC'C'_tB or asphalt) la[q�r LAan 1 foot in any <br />dimen�ion shall be broken int�� smaller than lfoot chunks ae .hall be cemoved feom the <br />existing pile of dirt that Aas b_en rec^ntly dFposited on the site hefore it is <br />covaced ovee vith nev rle3ll fill. <br />o�� � �� f�. , �z�� Z. L,z <br />n���o�ea o� e��,i,��ioh Da-}—� ��� <br />td <br />_��t17 '^' '^��C.� ��/ / —� <br />FINAI WSPECTION <br />Approvetl as ConSirur,IeO Dnte <br />09-30-03 6:OOFM <br />q 0309031 <br />OTHER «.50 <br />�'OTAL 22.50 <br />� k-1E_aG <br />A OM4758 <br />ACKNOWLEDGEMENT OF GONDITIONS <br />W <br />F— <br />'�A <br />VJ <br />W <br />O^ <br />+ <br />Z <br />O <br />�'/� <br />?�0 <br />L.J <br />a <br />The undersi9ned owner/applicant hereby agrees io hold and <br />savc hc•mless Ihe Clry ol [vcrett Irom any anA all claims lor <br />damages, costs, expr.nses, oi causes ol achon Ihal may arise <br />becausc ol mslallation and m;nnlenancc ol Um improvemenl or <br />olhci nght-ol-way usc herclo apphed lor antl Iwiher agrces to <br />removC same pon noiiCe Irom Ih �-ity and to replace public <br />pr ty d gcA Ihcreby. <br />,�— 9 ��3 <br />Si Bti � 1 Pppl � nl _-_ Dllc <br />WOHK AUIHORVED OV IMIS PGRMIT MU51 13[ STARTED WIil11N IUO DAYS OF �ATG V[fiMIT IS ISSULU �ND TM[R[�FT[� I$ TO BE DILIGENTLV PURSUGD <br />IO CO�dPLf_TION. 11n5 P[P1dli M�Y UG CANCGLIED llY 1H1: CIIY UPON ANV S10PPAGE OP VlOf1K ON iH15 PROJECT OVf.R 90 DAVS DURAIION <br />