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� -.... _ <br /> � PUBLIC WORKS °°18 6/21/2004 , <br /> PERMIT PuMlcWorksPertnflN P�oaoe-oi9 <br /> Buiiding Partnit M <br /> PUBLIC WORKS DEPARTMENT Planning Reference Y <br /> 3200 Cedar Stroot <br /> Evoratt,WA 90201 Public Works Fee S fj126.00 <br /> (425)257-8810 <br /> Gunrantee E <br /> OWNER NAME APPLICANT NAME <br /> ANOADDRESS: �CC� Council Of Snoho�iah Co. ANDADDRESS: PU9CL SOU�C E�eC� <br /> 1507 ilall Stteet PO Box 90866 <br /> EVERETT f111 98201 BELLEVI� A1 98009 <br /> PHONE: 42SZS�T3TO PHONE' q254623919 <br /> TAXPAiiCELI.D.� PROJECTADORE�S: <br /> PROPOSEDwoAK: Install appcox 1150' of 16" natu�al qas line <br /> nc..':1 �:. ,.�,�;.. <br /> �; «'c( !9 <br /> Qr`I_� �.�;i.•JV <br /> i Jl a� ' '� :;Q <br /> f.'f-�Ic . I .�.[ ;�t) <br /> PERMIT CONDI I'IONS ,",, `� <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 this permit and current City of Everett Desigr,and Construction <br /> Standards and Speci(ications. <br /> 3. Call Location Underground Service 4B hrs. before you dig. TOLL FREE NUMBER 1-800-421-5555 <br /> W <br /> 4. Provide (additional) erosion control as directed by the public worY � <br /> inepectoc in the field. A <br /> V� <br /> 5. ICeep city streeta clean at all tisea durinq cronstruction. � <br /> 6. Applicant ahall confir� all envicotuental requlationa have been aet. O <br /> 7. Applicant ahall protect city utilities froo da�age durinq conatruction. ' <br /> 8. Coocdinate any vork to be done in the cailroad ciqht-of-way with the raiicoad Z <br /> prioe to beqinning. O <br /> 9. 71.s per city approved plan dated 6-16-04 - if the alignient of the route ` <br /> changea a nev plan or as-builts ahouing the neu location ahall be aub�ittad to the A <br /> city. V/ <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> `��� �� � I �/�/1_ The undersigned owner/applicant heraby agrees to hold and <br /> �� V'r save harmless the Ciry ol Everetl fran any and all claims for <br /> �pprovetl bi Constru y�n Date damages,cosis,expenses,or causes ot action that may adse <br /> C �- � because of installafion and maintenance of ihe improvemenl or <br /> �" /// � �� � Z�`��C/ other right�o4way use hereto applied lor and turther agrees to <br /> /� � ��L;�"J/� re upon ratice f e City end to replace public <br /> FINAL INSPECTION r da aged thereb . � <br /> Approvetl as Constmcted Date � /n, � �/ <br /> /l <br /> ure ol Applkanl D <br /> WORK AUTHORIZED B'I THIS PERMIT MUST BE STAP.TED WIiHIN 180 DA'/S OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED <br /> TO COMPLETION.THIS PERMIT MFV BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRQIECT OVER 90 DAYS DURATION. <br /> �� �sZRS ti� <br />