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PUB�ic woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everetl, WA 98201 <br />(425) 257-8810 <br />TG F�;;i�lf�!".r�ar..3..i..zoo. <br />�o: - ' ., i4'.}�cp:�rr <br />_ _;°TH ?� _.. <br />_._.._.: ���. <br />PHONE: -,�- ^ ,- <br />4i.?:�L�Y.�'�. <br />TAX PARCEL I.O.a <br />:1L:fi?�i11=.' - <br />DESCRIPTION OF <br />PROPOSEDWORK':r'- �--.'�5� <br />L <br />. =-�i; <br />Dale <br />Public Works Permit @. �,: ,. r, : - -, - ' <br />Builtlmg Permit p ,_ �, r.; �._ _ _ <br />Planning Reference # <br />Public Works Fee 5 �„5 ' <br />Guarantee S � <br />APPUCANTNAME <br />ANDADDRESS�,i,� ,r�-t,4•.r�-"-. <br />i,; <br />PHONE: <br />PRQIECTAODRESS: <br />PERMIT CONDITIONS - . _ • _ , . _ ' i- _?; iT_F..-= i ? C = ' <br />1. All calls for inspeclion shall be made 24 hours in advance. <br />2. All work shail be performed in accordance with this permit and current City of Everetl Design and Construction <br />Standards and Specificalions. <br />3. Call Localion Uncierground Service 4B hrs. before you dig. TOLL FREE NUMBER 1-800-024-5555 <br />_.. : _. ._ a..,= .- ----_..� - -.. <br />. _'_IIIlE._C i.i.jB ,,_ �•_C ���L C1C�' :iT311�j3C:j Yr:iil. <br />. r�nn�.�t �lI ccnftr��� �iovns�K�uts to thr. ��;le yevr.-r. <br />�_.�..��� �--i�._.. �_ <br />". Tnst.all .��r�ion r,ntrol me;.�i[ea a� detenninyd b}• the k+bl?iY'!:`R4fyF'"`5'A� t�iY <br />ri r.- (?�"?'1° � <br />::idi._ated in the reascmable use Reva=u I pb-004, such as �lt �q2b, �tra�'�hajes <br />_.�,, ��L a�ns:�:r t�l�,nkets. : �,'- <br />_ dir2, r.ud, _. _._ or det�cis t� t�e tracked r,�tn Y09CI1=3`f. <br />;ve dCive��a�� ficr. :h•_ fcont pcopaetu line out to th? •tt�q?t p3vinp. <br />. � <br />. . '.,_f','=.'i. _ . _.' . . _ _ _. , .,r,..:.`.. �y:;_ � <br />/ / .�I <br />L'�i/ f ,Y't�)!A M <br />� e«+w� <br />. r.'�tiE��`v�M� �d�m <br />cS. <br />.� -.. . %S-' -. _ _ _. . <br />-�;� /�./ <br />../.j i! :C� .7 % (:'�/6'k'' <br />Appmvedlor Conslrutlion ato <br />as <br />Dale <br />S—Z/— 07 <br />W` <br />r <br />'�A <br />V/ <br />W <br />O <br />Z <br />� <br />H <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees �o hold and <br />save harmless Ihe City oi Everetl Irom any and all claims lor <br />damages, cosls, expenses, or causes ol action that may arise <br />because of ins�allation and maintenance oi the impmvement or <br />other nghl-of�way use hereto applietl for antl fuhher agrees to <br />removn same upon notice 1mm ihe Ciry and to repiace public <br />property damaged thereby. <br />Cfnnl�/�f-�'�/u�_ i O 1- /'i � CX <br />SignaWreolApplicanl Dale <br />WOI�K AUTHORIZED �V THIS P[RMIT MUS7 �E STAqTED WITHIN 100 DAVS OF DATE PERMIT IS ISSUED AN� THEFEAFTER ISiO BE DILIGENTLV PURSUED <br />TO COMPLETION. THIS PERMIT MAV OE CANC[LLED OV THE CITY UPON ANY STOPPAGE OF WORK ON?HIS PROJECT OVER 90 DAYS OU(i�710N. <br />LP1vP 1 %DEI DRTAB�R. INC. <br />