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� <br />PUB�ic woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMFNT <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425)257•8810 <br />Date <br />Public Works Permit # <br />Building Permil J/ <br />Planning Reference R <br />Public Works Fee S <br />Guarantee $ <br />°.jLF.l2QQ6 <br />Pwn,nl-nl, <br />:F,S��4.Oii <br />OWNER NAME nrru�.nrv i ��nmv <br />ANDADORESS: ppRT OF EUERF.TT ANDADDRESS: y,�lyy$ji H1IGL'.-P.EIL I•IILGLETON <br />pn ���� 5?g �28 134TH ST _k� !i�09 <br />E\'ERLT"f II.a. :�E2ii�=� El•'ERETT G!A :a�.'Oq <br />PHONE: ��r.,_t8�i)�;30 PHONE: Q_[i741,��i1(! <br />TAXPARCELI.D.M PR0.IECTADDRESS: -q.1, � r��T?1E VIE4� L'�F; _ <br />DESCRIPTION OF <br />PROPOSEDWORK: W MAfiIT.'E VIF.['1 DP: ST IhiPfinV`;htE}1TS FRJ <br />PERMIT CONDITIONS <br />1. All calls for inspeclion shall be made 24 hours in advance. <br />2. All work shail be p3ttormed in accordance with this permit and current City ot Everett Design and Conslruction <br />Standards and Specifications. <br />3. Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />'-�i. �)iijl�! T�� F.'j ''n11Yt Prr: nLp!'[: 2.1'T_�!:lf1�Li' (1!�j LiFr. . ._i:l?h <br />' 9-O <br />lor <br />FINAL INSPECTION <br />Approvetl ns Constructed Dale <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownedapplicant hereby agraes to hoid and <br />save hannless the City ol Everatl Irom any and ell d;imr lor <br />damages, cosls, expenses, or causes of action thal ma/ erise <br />because ol installation and maintenance ol lhe improve nent or <br />other right•of-way use hereto applied lor and further egrees to <br />remove same upon notice irom the City and to replace public <br />property damaged thereby. <br />SigneNre of Ap�licanl <br />Dale <br />WORK AUTHORIZED BY 7HIS PERMIT MUST BE STARTED WITHIN 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfEP IS TO BE DILIGENTLY PURSUED <br />TO COMPLEfION. "' IIS PERMIT MAY BE CANCELLED BY THE CIiY UPON ANY STOPPAGE OF WORK ON THIS PR0.IECT OVER 90 DAYS DURATION. <br />EPWP (7�) DATABAR. MC. <br />