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jy <br /> Date 6/9/2005 <br /> _ PUBLIC WORKS <br /> • Public Works Permit# n <br /> -NriwiPERMIT . — <br /> �� � Building Permit# <br /> PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street Planning Reference# <br /> Everett,WA 98201 Public Works Fee$ <br /> (425)257-8810 S-1 a 685.0 0 <br /> Guarantee$ <br /> OWNER NAME APPLICANT NAME 1149 -�:ia. <br /> AND ADDRESS: ??1,3NsoliBovElkiAND ADDRESS: MA ,MARX ' :fi FEN S. ASSOC66-5-0g/oil <br /> 41 Et: BOX 219 / 2903 B . TT AVE <br /> FREELAND IA 98249 i EVERETT ems. 98201 <br /> PHONE: PHONE: I <br /> 3603215374 4252 520320 <br /> TAX PARCEL I.D.# PROJECTADDR SS: <br /> 501 E MARINE VIEW DR <br /> DESCRIPTION OF <br /> PROPOSED WORK: rMPLEMENT CAP C ' CLEAN FILL <br /> d_ 7e > i72 - 72-07 <br /> � -/--5e' <br /> PERMIT CONDITIONS ¢Zc; — cf-L l -©c)z- <br /> 1. All calls for inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with this permit and current City of Everett 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 W <br /> ilm <br /> . 4. WorK to be done per approved plans dated /2$/05 6 .-)>y 4 i'``Cf eAl'e <br /> CALL RANDY, 42~ 3,:9-7403 FOR PUBLIC ii0PXS INSPECTIONS •�" ,-;i '-71 CO a..s C"i <br /> ems.,--, ,7:: a c <br /> ,ry 4� <br /> it� Cam!►�t 50 U g.�3° :,..3' Z <br /> ¢Z9-_fb4-132S `� A J"' 0 <br /> o <br /> r ACKNOWLEDGEMENT OF CONDITIONS <br /> /, ` The undersigned owner/applicant hereby agrees to hold and <br /> �� 61.-y&&44"/ � save harmless the City of Everett from any and all claims for <br /> damages,costs,expenses,or causes of action that may arise <br /> Approved for Construction Date because of installation and maintenance of the improvement or <br /> other right-of-way use hereto applied for and further agrees to <br /> remove same upon notice from the City and to replace public <br /> FINAL INSPECTION property damaged the eby. <br /> Approved as Constructed Date , f ��,, ! <br /> SnatuApplicant Date / <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED <br /> TO COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br /> EPWP(7/06) DATABAR,INC. <br />