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pus�ic woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Streel <br />Everen, Wq gB2o7 <br />(425) 257-8810 <br />--' 1030 BROADWAY ANDAO <br />E��TT �+ 98201 <br />PHONE: 92S344O6OQ <br />PHONE: <br />TAXPARCELI.D.M 00438725�00900 PROJEC <br />DESCRIPTION OF u <br />PROFOSEO WORK: <br />PERMIT CONDITIONS <br />Date <br />3/B/2005 <br />Public Wolks Permit N P�Q503–010 <br />Building pe��t N <br />Planning Reference N <br />Public Works Fee $ 50 . 00 <br />Guarantee g <br />SHOiT gR11D <br />1314 E l�4hRINE yjEW DR <br />1. All calls for inspection shall be made 24 hours in advance - phone (425) 257•8810 <br />2. All work shall be peAormed in accordance with Ihis permit and current City ol Everelt Design and Construclion <br />Slandards and Specifications. <br />3. Call Location Underground Service 4B hrs. before you dig. TOLL FREE NUMBER 1-800-42q-5555 <br />�. Applicant shall usa caution when entecinu and exiting the lauilding. W <br />5• Thls FEra�it to entec is only g��� f�1 one day, Sunday, March 13, 2005. 41ork shail � <br />be done ovec a peri�,d uf approximately 2 houea. � <br />G. The buildinq muat be ce�ecured after this ��rk i� cemplete. � <br />� s <br />lor Construction <br />FINAL INSPI:CTION <br />Appmvetl as Constructed p��e <br />3 .. js-�s <br />'�r0�-•�I��/ ScCU✓'C <br />�� r Tu n-, r�- <br />� �B <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Tho undersigned owner/app�icant hereby agrees to hdd and <br />save harmless the City of Everett from any anA all claims Icr <br />damages, costs, expenses, or causes of action that may arise <br />because of installation and maintenance ol the imprrnement or <br />other righl-of-way use hereto applied for end further agrees to <br />remove same n notico from tho City and to replace pubiic <br />propert�r,ye � thereby. <br />/ � <br />SignalureolApplica� � ��-1��� <br />Dale <br />WORK AUTHORIZED !iY THIS PERMIT MUST BE S74RT[D WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE OILIGENiLY PURSUED <br />TO COMPLET�ION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURAi1pN, <br />W <br />O <br />� <br />Z <br />O <br />/F-� <br />V/ <br />0 <br />a <br />