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,� �,: <br />/���.� <br />� <br />PUBLIC �YORKS <br />PERIIAIT <br />PUBLIC WORKS DEPAR'MENT <br />32Q9 Cetlar Slreet <br />Everetl. WA 98201 <br />(4�5) 257-8810 <br />MIYUMVVIICJJ. . .'.`\� : . . <br />.� -'L-_Fr --.. -.- <br />PHONE: <br />TAX PARCEL I.D.a <br />TO �OSTING....��" °....� � <br />�:; r_ <br />�APPLICANT NAh1E <br />ANDADDRESS: <br />PHONE: <br />PRQIEC7ADDRESS: <br />DESCRIP710N OF <br />PROPOSED WOPK: . ... . . . ' .'..... � .-. .... _. . . <br />. . - .�.:.Tr , , '_• ,.. ... <br />PERMIT CONDITIONS <br />Oate <br />Public Works Permit R' <br />Building Permil M <br />Planning Reterence x <br />Public Works Fee S <br />Guarantee S <br />f-��li�?n-. <br />//1 J�-r - <br />fi'e�; - <br />1. All calls for inspeclion shall be made 24 hours'� advance. <br />2. All work shall be performed in acwrdance wilh this permit and cwrent City of Everett Design and Construction <br />Standards and Specitications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />_.. - —._ . _ .__ � . .;?, -"- - _-• ' - ' <br /><nm.=nr �,,. lot _ ar�,e�� ocee �7unqaco lot :�ha1.7 bn the e�e <br />'ci� <br />W <br />� <br />� <br />N <br />W <br />O <br />� <br />Z <br />O <br />H <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undorsigned owner/applicaM hereby agreos to hold and <br />save h�rmless the City of Everett Irom any and all claims lor <br />damages, costs, ex�enses, or causes ol action Ihat may arise <br />because o� installation a�itl �naintenance o'the improvement or <br />olher righl-oi-way use hereto applied for and funher agrees to <br />remove same upon nolice irom �he Ciry and to replace public <br />property damaged thereby. <br />c��. _ :1..��� �=t�d.,.�.--1�_S'�l� <br />S�gnature ol Ap�lrcant Dale <br />WORK AUTHORIZED dY THIS PFRMIT MUST BE STARTED W�THIN 180 DAVS OF DATE PFRMI7 IS ISSUED AND THEREAFTER IS 70 BE DILIGENTLY PURSUED <br />i0 COI.IPLETION. TIiIS PEFMIT MAY BE CANCELLED 6V THE CIN UPON ANY STOPPAG� OF WORK ON THIS PRQIECT OVER 90 �AVS OURATION. <br />[PIYP IilW) DATABAR.INC. <br />