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PUBLIC WORKS Date _ _ �; � • � <br /> Public Works PermitjlFObV2—i�_._� <br /> PERMITBuildingPermit�i EOb01—Cti`. <br /> PUBLIC WORKS DEPARTMENT , Planning Reference# <br /> 3200 Cedar Street <br /> Everell,WA 98201 � „� 7 Public Works Fee S s�� � <br /> ,4z5��B�STING. �u�. l � ��o, •- . <br /> .....................«.�.« Guarantee 5 <br /> OWNER N,�M�.�.,I C F.7.'i APPLICANT NA�dE <br /> AND ADDF7E55. AND ADDP.ESS: <br /> lC''_:' F:'!C]''Ei: T�.`,n <br /> �:�F.ETT a'� :�5�n1 <br /> Pi+oNe: �7��;55981n PHONE <br /> TAX PARCELI y PROJECTADDRESS�. <br /> '�IfSO�IiU:���1`.1�1! 1•�j�_:. <br /> oescairnoNp�W C='r.i:hC'E p���,r.: r.:,:�.:';:._'_-.r. i•:i= <br /> PROPOSED WOFiK: <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance - phone(425) 257-88�0 <br /> 2. A!I wo�k shall be perlormed in accordance with �his permit and current City of Everett Design and Construction <br /> Standards and Specilications. <br /> 3. Call Location Underground Service 48 hrs.before you diy. TOLL FREE NUMBEii 1•800-424-5555 <br /> 9. !ec:uc_ ;,-_d•_ .,_�r.�c aictm:! rL- csac: caiag�� _ _ _= :is�: c,t ,--_'- 1'=c t''i- � <br /> , _ u;, .._ - <br /> '+ . 7lllhl.'C ii1 CO��j'r�_��: �jr:.;i1J�'��=�UL,,�r�_. Cl7E .'.!�]� ._ - _ <br /> _ � <br /> ��. i. . ."t: � .. . . .�:- -. t 1'. .. ,`�IF1� :: . . �.Il '..�1' �1 .I i . , � _ r�,.: � <br /> � - , . . . .. . i �t . ; 'tI:< . . '1 _tilt <br /> . - _ _ . . . __ . -:1 �.:Ib� _.. .. <br /> W <br /> O <br /> � <br /> Z <br /> O <br /> H <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> i / <br /> /"/ / �/ The undersigned owner,applicant hereby agrees to hold and <br /> _1 � �:K t'trY �' �`Y� �ave harm!ess the City of EvereU trom any and all aaims for <br /> Appi �� lor consimcUon ate damages,cosis,expenses,or causes ol action ihat may arise <br /> ��� because of installalion and maintenance ol Ihe improvement or <br /> �7_' 2 _J� other right�obway usa hereto applied lor and further agrees to <br /> / remove same u on notice irom the City and to replac=public <br /> FINAL INS CTION propeny dam ed ther <br /> Appmvetl as Consimcted Date <br /> _ _ _ _ —✓�.— _ <br /> Signat e of ppOcan� Date <br /> WORK AUTHORV_ED BV iHIS P"eRMIT h1U5i�E STAfiT[D YJRHIN 180 DAYS OF DATE PERh11T IS ISSUED AND 7HEREAPTER IS TO BE DILIGENTLV PURSUED <br /> t0 COt.7PL[iION iH15 PLR�dIT 1.1Av�[CANCELLLD�Y 7H[CiTv UPON ANV STOPPAGE OP WORK ON THIS PROJECT OVEfl 90 DAVS DURATION. <br />