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Pue�ic woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everetl. WA 98201 <br />(425) 257-8810 <br />T^ p�STING <br />OWNERNAME <br />ANDADDRESS: <br />PHONE: <br />TA% PARCELI.D.r <br />M� 2 6 2001 <br />PHONE: <br />PROJECTADDRESS: <br />Date <br />Public Works Pertnii # <br />Building Pcrmil M <br />Planning Reference k <br />Public Works Fee $ <br />Guarantee $ / <br />10/3/2000 <br />PW0010-003 <br />CRev � scd) <br />25.00 <br />Dave Parry - <br />1424 W Mukilteo Blvd <br />EVERETT WA 98203 <br />(425)337-5550 <br />DESCRIPTIONOF Make new connection to Catch Basin <br />PROPOSED WORK: <br />PERMIT CONDITIONS <br />1424 W Mukilteo Blvd <br />1. All calls lor inspeclion shall be made 24 hours in advance • phone (425) 257•8910 <br />2. All work shall be performed in accordance with this permil and current City of Everett Design and Construction <br />Standards and Specitica�ions. <br />: Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />4. As per submitted plan by Bruce Engineering dated 6/20/00. <br />5. This permit covers only the work to be done in the public <br />riqht-of-way (not the portion on private property). <br />6. Call public works inspector Dennis Gabelman @ 339-7403 for <br />inspections. <br />�����D <br />o�To D <br />� �o <br />CITY OF EVERETT <br />Permit Services <br />�d dv� <br />v i�/f('j� <br />�!Qi1rAi 1-G <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />V/ <br />W <br />0 <br />� <br />Z <br />0 <br />� <br />0 <br />a <br />The undersigned ownedapplicant hereby agrees to hold and <br />save harmless ihe City of Everetl Irom any antl all claims for <br />damages, costs, ezpenses, or causes ot action thal may arise <br />because ot inslallation and maintenance of the improvement or <br />other right•ol�way use hereto applied r and turther agrees to <br />remove same upon notice Irp t Ci and to repWce public <br />prop - amaged tt cr b' <br />SignaWreolApplManl le /�'��� � <br />WORK AUTHORIZED OV TMIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSU[D <br />70 COMPLE710N. THIS P[RMIT MAV BE CANCELLED BV THE CI7Y UPON ANV STOPPAGE OF WORN ON THIS PROJECT OVER 90 DAYS DURATION. <br />