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� PUBLIC WORKS PERMIT Date enizo�s <br /> �` Public �"Jorks Permit # PWUV1308-001 <br /> '� ' Cny of Everett Public Works Department <br /> ' 3200 Cedar Street Buildinq Permit #. W1307-003 <br /> �`�� . � Everett V��A 5820� Planning Reference # <br /> (�25j257-8870 <br /> Public Works Fee S 5 40 00 <br /> Other 5 <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDR[SS: <br /> CLAYTON STRIPHAN Y <br /> 2428 TAYIOR DR <br /> EVERETT WA 98203 <br /> PHONE: 2067154208 PHONE: <br /> TAX PARCEL ID# 00396°CG006200 SITE ADDRESS: 10119 1 ST PL W <br /> UESCRIPiION OF PROPOSED WORK: <br /> INSTALL FOUNDATION TIGHTLINE <br /> INTO SUMP AT REAR OF PROP[RTY <br /> PERI�iIT CONDITIONS <br /> 1 All calls for mspection shall be made 24 hours in advance <br /> 2 All work shall be pertormed in accordance w�th the permd and current Gty of [verett Des�g� and Construction Slandards <br /> and SpecdicaUons <br /> 3 Call Location Underground Service 48 hrs b�fore you dig TOLL FREE NUMBER 811 <br /> 4 All work shall conform to sepGc permit #36874 and plan approved by Snohemish Health D�s!��ct dated 8li113 <br /> Evidence o! Snohomish Health Dislrict inspection ard hnal approval o`septic system repa�r work must be subm�Ued��; ; <br /> to the City o(Everetl pr�or to f�nat approval of this permit � � _'� '-�' W <br /> —, . � <br /> Ti r r_�c_� '-. r <br /> The City requests prior nohfcabon of - and to be present at - Ihe pre-conslruction conference bet�gen�l�ip;$ep�. � <br /> des�gnerleng�neer, cert�fied installer and the Snohmish Health DistncL "''— `-� <br /> u, r�c� <br /> Your publ:c works mGsector is ChN Lindman Please caii (4Z5)257-7269 for any mspecUons or ques6ons �� _',�.' � I <br /> .� ■� <br /> �', <br /> �.� ?j � <br /> .C. � �,) <br /> �, � , <br /> ;��!'_ - :,c% <br /> _ �, ' -'Ci <br /> ,;�, <br /> � a i <br /> ACKNOWLEDGE�.ICP1T OP CCtvDII IONS <br /> 1 he urde�sgned ownedapphcant hereby agrees to hvld and <br /> save hannless Ihe City ot Everett(rom any and all Ga.m;loi <br /> tlamages. costs,expenses, or causes o(action Ihat may anse <br /> � �/�/ � because of installation and maintenance of Ihe nnprovemenl <br /> , or other nghbol-way use hereto apphed tor and furthcr agrecs <br /> A °roved for ConstrucUon � Date to remove san,e upon not�ce (rom the City and to replace <br /> pp public property damaged thereby. <br /> f���CTlO� Date � ' �"` `"' " o /� �// 3 <br /> Approved as Cons�ructed ��'Z���3 S:gnat��re ot Appiica Date <br /> l":ORK AUTHORIZED OY 7NI5 PERMIT MUST BE STARTED WITHIN 180 DAYS OF DAT[PERMiT IS ISSUfD AND TNEREAFI�ER IS TO BE DILIG[NTLV <br /> PURSUED 10 COP1PLtT10�Y. TN15 PERF1fT P1AV�E CANCCLLED 8�'THE CITY UPOW ANY 5T0?PAGE OF 1NORK ON THIS PROJ[Ci OVER 90 DAYS DUR4TION <br /> �� Y2 <br />