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PUBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />32DO Cedar Street <br />Everett, WA 98201 <br />(425)257-8810 <br />'NGUYEN BINH VAN <br />5923 3RD DR W <br />EVERETT WA <br />PHONE: 4257531549 <br />TAX PARCEL LDA <br />PROPOISED WORK: HOUSE ADDITION <br />APPLICANT NAME <br />AND ADDRESS: <br />98203 <br />PHONE: <br />PROJECTADDRES <br />Date 5/4/2007 <br />Public Works Permit# PW0705-012 <br />Building Permit p <br />Planning Reference p <br />Public Works Fee $ <br />Guarantee $ <br />C0704-042 <br />$25.00 <br />-.-I�l?JAN� 63.QOB_ <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hours in advance. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800-424.5555 `W` <br />4. Install erosion control measures per City of Everett Standards for small parcels. = <br />S. No dirt, mud rocks or debris to be tracked onto roadway. <br />For inspection call Randy Allen, 425-339-7403 W <br />O <br />n <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, expenses, or causes of action that may anso <br />because of installation and maintenance of the improvement or <br />other right-of-way use hereto applied for and further agrees to <br />remove same upon notice from the City and to replace public <br />—property damaged thereby. <br />bs 3D( <br />Signature of Applicant ' Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO DE DILIGENTLY PURSUED <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />EPWP (?=) DATABAR, INC. <br />