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P�JBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTMC-NT <br />320� Cedar Sireet <br />EveretL WA 98201 <br />(425) 257�8810 <br />OWNEfi�`r��� <br />ANDAUDRESS:;OIQ _OTfi SE <br />EVERETT �::, �E205 <br />9255u3: E�� <br />PHONE: <br />TAX PARC[U.D. d: •' .. ._ ...'.. l.. �.. <br />.�iDG1NG ` :i?�� _�: <br />�ESCRIPTION OF <br />PROPOSED WORK: <br />PERMIT CONC!TIONS <br />m <br />Dete �li/�pi�OQr, <br />P�VO..,��-ii'_•5 <br />Public Works Permi� # ��i �, 1 �_.-i _. ' <br />Bwlding Permit # <br />Planning Reference tl <br />Public Works Fee S � <br />Guarantee 3 � ��� <br />APPLICANT NAAIE -L 'l '1 l � <br />nN�nooaess: ;pNDRA lLDE3�. <br />PHONP '�L�,l-1?..i!1' <br />PROJECT A��RE55.�::1; ��. �.O�i.Ef FLLEF Ab� <br />1. All calls lor i�spection ehall be made 24 hours in advance - phone (425) 257-8810 <br />2. All work shall be per(ormed in accordance with ihis permit and current City of Everett Design and Construclion <br />Standards and Specilicalions. <br />3. Call Location Underground Service 48 hrs. betore you dig. TQLI FREE NUMBER 1-800-424-5555 <br />9. Connect :;�.le se�.�r: �e� ._ ....and;[d N': i,qi, 6(12, riti. <br />5. ronne,:t ccoic�:r, �ic.un:p._u'-s -: the �jG31173�7.3 •:]tem �;c_.:de�. :�:� this ]�,r. <br />h. S115C311 BCb31017 Ci41TLi�1 IGBti3lI1B3 F�BL I.lCY O! �EVi•Cett Stil�ildLQ; .`UL 3rfi:t! . r��tit.'.'-'ir: <br />. i1 C3trh !�awin 35 jJBC Cl�}' SL311�dCd i'Zd❑ 1��iI,S.Z 4/1t�1 d�73:7 CC3:? �?@C :i:.dil:id[•j t: i:! <br />�4:0 is c?quiced foi the paLl:iny scea. <br />�. Paeking pa�in� r:ha11 be a minimum uf 2" of cla�e 'B' as�>hait ovec 4" of ccushe�i <br />sucfa�•inq tc�pcoue3-., <br />TO POSTING � � <br />ACKNOINLEDGEMENT OF CONDITIONS <br />J <br />W` <br />r <br />� <br />Y/ <br />W <br />O <br />� <br />Z <br />O <br />H <br />� <br />O <br />a <br />The undersigned ownec applicant hereby agrees to hold and <br />save harmless the City ol Everett frem any and all ciaims for <br />damages, costs, eMpenses. or causes ol action thal may arise <br />because ol installation and maintenance of the improvement or <br />other righbot-way use her�to applied for and fwther agrees to <br />emove same upon nolice imm ihe Ciry and to rep�ace pubhc <br />p oerty aged Ihereby. <br />c o � � `i��- -- <br />9 na!ureo Applicant Date <br />K'OfiK AUiHOR�ZL .iv 1 H'�S FE.R61�T F.tU51 (3E SinR7ED l'JiTHIN 180 DAYS OF DATE PE T IS ISSUED AND'HEREAFTER IS 70 8[ DILIGENTLV PURSUED <br />ro COMPI_f6l ION. tHlS PLRM17 L9AV CF CANC6LL[� �V THf CIIY UPON ANv STOPPAGE OF WOF7K ON THIS PROJECT OVEF 90 DAYS DURATION. <br />