Laserfiche WebLink
, PUBLIC WORKS Date O(i/11;1�0� � <br /> ' Public Works Permit N pW020b—G07 <br /> PERMITBuildingPennitp LU205-0?,1 <br /> PUBLIC WORKS DEPARTMENT Planning Relerence a <br /> 3200 Cedar Street <br /> Everetl.WA 98201 Public Works Fee S $'„�,, , �p <br /> (425�257�o pOSTING �UN 0 3 200 <br /> Guarantce S <br /> OWNERNAMEDFYDEI� VIRGINIA L Lv RORERT AND DDRESSME <br /> ANUAODRE55: . <br /> 11516 �NL AVE SE <br /> EVEPETT We� yg2Og <br /> PHONE� '��r��b�O1�9 PHONE: <br /> TA%PARCELI.D.M OU�J�I.36OUGOL�JO? PROJECTA�DRE55: � 1F13 �II[1 V <br /> DESCRIPTIONOF nEpLACE MANUFA�"TURED Hi�t•iE <br /> PROPOSED WORK: <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance-phone(425)257-8810 <br /> 2. All work shall be performed in accor�ance with this permit and currenl Cily of Everett Design and Construclion <br /> Standards and Specilications. <br /> 3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800-424-5555 <br /> 4 . Fe�_�.�nn�:_t exi,;titig wat��r s�-tvic� to �na�,� Lome. W <br /> 5 . Applicant. musC contact t.he Snohomish Health Uistrict to insui�� L?:�ir � <br /> ! lia existin�J dra.in field is adequate Eor the new use. � <br /> o . gplasl� bluc}:s shall nnt dr,_�i�i onto adloininy propei �;y, <br /> 7 . In-Ca1? ..tosinu conrr�,l m�,.�uui��._ _� - -: i� ,,., .,,d by Cti.� Piibli�� ia��r'}:�.; m <br /> i�i: J�� �.i�t . <br /> O <br /> Ob-^_5-QZ ^•43PM � <br /> N U2050�1 "' <br /> BlJll.� 205.05 O <br /> SFCHG 4.50 <br /> PLUME 7.00 <br /> DRTVE �5.00 � <br /> T�TAL �41.55 � <br /> Ch1Eh` 24Y.'d6 <br /> A OM3527 V <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> / y��/{�' L�a O� The undersigned owner/applicant heraby agrees to hold and <br /> %� �' ✓'✓ �� save harmless Ihe Ciry of Everetl imm any and all tlaims lor <br /> A rovM lor ConsVuttion Oaie° damages,costs,enpenses,or causes ol action Ihat may anse <br /> because ol inslalWtion and maiNenance ol the improvemen�or <br /> // �^ other right�ol�way use hereto npplied lor and lunher agrees to <br /> I T�✓ K�—��� remove same upon no� e ir the City and�o replace public <br /> FI INSPECTION p�D e�ged I _ <br /> Approvetl as Conslmcietl Date //y�� <br /> Sign�lufe ol Appl�canl � aie —� � <br /> WOfiK AUTHOR'ZED BV THIS PERM17IT MUST BE STARTED YJITHIN 180 OAYS OF DATE PERMIT IS�SSUED AND THEFiEAFTER IS TO BE DILIGENRY PURSUED <br /> TO COIAPLETION.THIS PERMIT MAV BE CANCELLED OV THE CITV UPON ANY STOPPAGE OP WORK ON THIS PROJECT OVER 90 DAYS DURAfION. <br />