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PUBLIC WORKS PERMIT <br />Date: <br />Public Works Permit #: <br />5l13I2011 <br />PW 11 GS-008 <br />� Ciry of Everett Public Works Department <br />-p,�-,,r.e; �,-: <br />3200 Cedar Street Buildinq Permit #; <br />� Everett, WA 98201 Planninq Reference#: <br />� (425) 257-8810 <br />i; Public Works Fee S: 5 407. i5 <br />ji Other S: <br />i <br />OWNER NAME AND ADDRESS: I APPLICANT NAME AND AD�RESS: <br />BALLOU HELEN M <br />9625 4TH AV[ W <br />EVERETT WA 98204 <br />PHONE: <br />AX PARCEL ID # 00480200701100 <br />DESCRIPTION OF PROPOSED WORK: <br />SITE WORK FOR FiJTURE 3-HOUS[ DEVELOPMENT <br />HARVEY DEVELOPMENT LLC <br />9900 AIRPORT WAY #SUITE E <br />SNOHOMISH 98296 <br />PHONE: 3605684801 <br />SITE ADDRESS: 9825 4TH AVE W <br />'�c� uOS�riNG_ ocr 2 � zo�� <br />P[RMIT CONDITIONS <br />1. All calis for inspection shall be made 24 hours in advance. <br />2. All work shall be pertormed in accordance with the permit and current City of Everett Design and Construction Standards <br />and Specifications. <br />3. Call Location Underground Service 48 hrs before you dig. TOLI FREE NUMBER 811 � <br />��,�� �" H // <br />Approved for onst ction Date <br />�����f���_/ — <br />F�SPECTION Date ��t �� // <br />Approved as Constructed J <br />-�'� <br />�J�=',-:. <br />� if.ii��� j <br />c. <br />�� a.� <br />�T <br />_; <br />�-+ IV <br />W <br />� <br />1�1 <br />� <br />� <br />O` <br />✓ <br />z <br />0 <br />� <br />� <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Thc undersigned owner/applicanl hereby agrees to hold and <br />save hannless the City of [verell frotn any and all claims for <br />damages, cosls, expenses, or causes of action lhal may arise <br />Uecause o( installation and maintenance of the improvement <br />or other right-of-way use hereto applied for and further agrees <br />lo remove same upon notice from lhe Ciry and to replace <br />public property d� naged fhereby. <br />;��� < :✓--_,- : z�� . <br />Si�hature ot plicant Dale <br />WORY, AUTHORIZED GY 7HI5 PERPIIT h7U5T Q[ STARTED \VITHIN 180 DAYS OF DATE P[Rh1IT IS ISSUED AND TNEREAFTER IS TO BE DILIGENiLY <br />PURSUED TO COi��iPLET10N. l HIS PERFIIT 14A\' [3F CA�<CELLED C+1' THE CITI' UFON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />