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ry <br />PUB��c woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Evered, WA 98201 <br />(425) 257-8810 <br />OWNER NAME <br />AND ADDRESS: p�T OF FVERF.TT <br />po sox sse <br />�yrTT iA 98206 <br />PHONE: q252593164 <br />« <br />/ <br />Date <br />si25/2004 <br />Public works Permn M pO0903-025 <br />Bui�ding Permit M <br />Planning Reference M <br />P�oi�� w�s Fee a 564.50 <br />Guarantee5 �D�_3�,4o��p 83� <br />APPLICANTNAME ��� JOffil J, PE <br />AND ADDRESS: <br />PHONE: <br />PROJECTADDRESS: IOOO Y FP�RINC VISt aR <br />PR POSED WORK: lOTH STREET BO71T I.7�IINCH REPAIRS <br />-FJ(C.�MTE AND HAUL IN APPROXIMATELY 500 CY OF l41RTsRI71L <br />( SEP71 t10T t�EDED FOR REP7IIR ) <br />PERMIT CONDITIONS <br />1. All cails far inspection :��hall 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 Design and Consiniction <br />Standards and Specificati�ns. <br />3. Call Location Underground Scrvice 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />4. Reep City atreet clean at all tiaes <br />(iJ-�:i!-i;C »';�`��fl <br />�1 040:02`i <br />U��i�c'i :�4,.5(� <br />1 i i +� 54..�i� <br />i: i-�E.=�. �0 <br />; St'�??63 � <br />,rA <br />V/ <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Tho undersigned ownerlapplicant hereby agrees b add and <br />save harmless the Ciry ot Everetl trom any and all claims for <br />tlamages. costs, expenses, or causes of action thst may arise <br />because of installation and maintenance of the imprmement or <br />other right�ol-way use hereto appiied lor and further egrees to <br />removo ume upon notice from the Ciry and to replace public <br />properry damaged thereby. <br />S' ture ol Applicant — Oale�O� <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENiLY PURSUED <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TMIS PRQIECT OVER 90 DAYS DURATION. <br />