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PUB�ic woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Slreet <br />Evcretl, WA 98207 <br />(425) 257•8810 <br />s�p��ao/5z SPV <br />LAKESHORE INVESTMENT CORP <br />8325 21?.TH ST SW �103 <br />EDMONDS WA 9802 <br />PHONe: ( q25 ) 774-6599 I PHONE: <br />------------ — <br />7AR PARCEU.O.M PROJEC <br />DESCRIPTIONOF ANTENNA ON EXISTING POLE <br />PROPOSED WORK: <br />F�W <br />PERMIT CONDITIONS <br />Date <br />Public Works Permit p <br />Building Permit R <br />P�anning Reference M <br />Public Works Fee 5 <br />Guaramee S <br />12/28/2000 <br />PW0012-015 <br />8�012—�1� <br />$ 25.00 <br />1. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br />2. All work shall be performed in accordance with Ihis permit and current City of C-veretl Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424•5555 <br />�' '°ts � P��h ��, � w; -� �.., ; �, <br />t»-^6-Ol 10:59AN <br />u coi�oio <br />EUILLI 581,25 <br />SRCNG 4.50 <br />II OO1r�SJ <br />O7HcR 25,00 <br />�-OTAL 61.0.75 <br />,a DM].201 <br />W <br />H <br />� <br />m <br />O <br />� <br />Z <br />� <br />�"' <br />�^ <br />Ci-�cli �/00 <br />ChiE;: <br />CHANGE �J�) <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless the Cily of Everett irom any and all claims for <br />damages, cosls, expenses, or causes of actio� that may arise <br />because ot installalion antl maintenance ol the improvement or <br />other right-ol-way use hcreto applied for and further agrees to <br />remov same upon n ti Irom the Ciry and ro repl ce public <br />rop tlamaged th e . / ���� <br />Si wlwe I Appl ni Date. <br />WORK AUTHORIZEO BV THI; PERMIT h1UST BE STAfiTED WITHIN 180 DAYS OF DATE PEFiA!IT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLV PURSUED <br />TO COMPLETION. THIS PEFMIT MAV BE CANI:ELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURAiION. <br />