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y;; PUBLIC W�ORKS PERMIIT <br />City of Everett Public Works D�parlment <br />_ ,� � ,_ , 3200 Cedar Street <br />�`:%;�- '. =•r%✓' Everelt, WA 98201 <br />(425) 257-8810 <br />OWNER NAME AND ADDRESS: <br />GREENLEAFJOSFPH M <br />322 ALVERSON BLVD <br />EVERETT WA 98201 <br />PHONE: <br />4X PARCELID # 00439167901200 <br />DESCRIPTION OF PROPOSED WORK: <br />INSTALL CATCH BASI�JS IN PARKING LOT <br />Date: <br />Public Works Permit #: <br />Buildinp Permit #; <br />Planninq Reference #: <br />Public Works Fee S: <br />Other $: <br />F.r'PLICANT NAME AND ADDRESS: <br />COOPER RANDY <br />PATH AMERICA <br />PHONE: 3607226392 <br />6111I2013 <br />PW'I 306-012 <br />S 25.00 <br />SI7E ADDRESS: 2925 W MARINE VIEW DR <br />PERMIT CONDITIONS <br />1. All cails (or inspection shall be made 24 hours in advance. <br />2. All work shall be performed in accordance with the permit and current Ciry of Everett Design and Construction Standards <br />and Specifications. <br />3. Call Location Undergro�nd Service 48 hrs before you dig. TOLL FREE NUMBER 811 � <br />Per aoproved plans dated 6.10.13. <br />Your Publlc Works Inspector is Randy Allen. Call him at 425-339-7403 for questions and inspections. <br />AppiW�Q <br />._ , <br />as Constructed <br />Date <br />�- � - i3 <br />Date <br />W <br />E" <br />� <br />� <br />� <br />0 <br />h <br />z <br />0 <br />H <br />� <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless the City of Everett from any and all claims for <br />damages, costs, ezpenses, or causes of aclion that may arise <br />because of installation and mainlenance of lhe improvemenl <br />or other right-ot-a�ay use herelo applied for and (urther agrees <br />to remove same upon notice from Ihe City and lo replace <br />public property damaged Ihereby. <br />„� � .i <br />;, � ,�:�:t.��.��r�-� W%,�!���; 3 <br />Signalure of Applicant � Date <br />\';ORK AUTHORii [D f3Y THIS PGR611T 14U5T �[ 57ARTGU IVITHIN IBO DAYS OF DATE PERh1IT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY <br />PUIi;UFU TO COFiPLE110N. ��I1I5 PL'RI41T h1:�Y B[ CANC[LLED 8Y THE CITY UPON ANY STOPPAGE OF \VORK ON THIS FROJECT OVER 90 DAYS DURNTION. <br />' �,�,' <br />