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; / <br /> o�i� <br /> PUBLIC WORKS PublicWorksPermiix <br /> PERMITB���d�:,q�<<m,�� <br /> PUBLIC WORKS DEPAR7MENT Plana�ng Rolcrence H <br /> 3200 Cetlar Strect <br /> Everett,lNA 90201 Public Works Fee 5 <br /> �a2s1 zs�-eeio <br /> Guarantee 5 <br /> OWNER NAME APPLICANT NAME <br /> ANDADDRE55: , �;':":-'r..- �-, a�.= - . ANDADORESS: .. <br /> , `..�' _ ':. .. Lrt' u 3 2��7 <br /> - - �.. 1�0 POSTINGy........................ <br /> PHONE: - � PHONE: <br /> TAX PAflCEL I.D.k PRQIECTADORE55' <br /> DESCRIPTIONOF . . . <br /> PROPOSED WORK: <br /> PERMITCONDITIONS . .� . � <br /> 1. All calls(or inspection shall be made 24 hours in advance. <br /> 2. All work shall be pedormed in accordance with this permit and current Cily of Everett Design and Construction <br /> Slandards and Specilicalions. � <br /> 3. Call Localion Underground Service 48 hrs. be�ore you dig.TOLL FF� �UMBER 1-800-424-5555 ` <br /> r <br /> � <br /> .._ - - - - - . . , .._ ,. ... . � .- _r.e :iLn.n-�•-t�_ � - � <br /> � il] sro i7n cnntec,l mFi ura� �.�� r;ty nf g�• � <br /> rx�. .���At 1 riat:�-fi�l frr�rt fc�u�9ati�,n, sSrie4_iP . . _ ._. . . , - , -. <br /> Ql'rEj, �r,-1IS1C•P_�j 91`0. NC •✓a3C1q�7 OI mdt@Yi_:1 18 3ZZ�.A?it or n,i. b�l ��iil•'�. . � � O <br /> ;:ct, mu.i� co,1:s ot de�b� :s to k� teFcked onto craJWayi . <br /> � cil�iing materials r.o L+�= e[ackNd nn aidevalk� an�i si�f�r.ralks to ix irept c �. - ' <br /> �.��r p=�leatrirm travFl. � <br /> :� <br /> . . . . _ . . �i , _. <br /> . . . - .... � �- - , . . � . . . -. . . _. .. t,�. 4. . _ _ .- � O <br /> r <br /> N <br /> O <br /> a <br /> � � ACKNOWLEDGEMENT OF CONDITIONS <br /> � ' � - The cntlers�gned owner,�applicant her�by agrees to hold and <br /> � ��, --�/,, �^7 save henniess Ihe City ol Everett from any and al1 claims for <br /> I �:C�/" "c^� `,/� tlamages,costs,ezpenses,or causes ol action ihat may arise <br /> A�H oN veU to�Conslruction ����a/ becauso of instaltation and maintenance ol lhe Improvement or <br /> , olher ri f�way use hereto applied br antl futlher aqmes lo <br /> I ,�y/�f� .��_ _ remov i �e upon noiice Irom Ihe y a d to roplace pu�hc <br /> CINSPECTION pfOpCh' gCdlhCfBby. <br /> - ACProved as ConslrueiCd OAio I <br /> 1 -/9- r'7 /''ti`-� � � 07 <br /> �/ _ Signnt pp��canl Dale <br /> V/ORK AUTHORIZED BV THIS PERMI7'MUST BE STApTED WITHIN 160 DAVS OP DA7E P[RMIT IS ISSUGDAND THEREAPTER IS TO�E OILIGENTLV PURSUGD <br /> 70 COMPLETION.THIS PEHMIT MN[3[CANC[LLEO OV TH[CITV UPON ANV STOPPAGE OF WORK ON THIS PROJECTOVER 90 DAVS�URATION. <br /> i rv;r i,-no� <br /> onrnon�.mc <br />