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PUB��c woRKs <br />PERMIT <br />PUBLIC WORHS DEPARTMENT <br />3200 Cetlar Street <br />Evere�I. WA 98201 F,EB 0 S 2006 <br />��!��iNG <br />OWNERNAF�5,15 .�7 ZhO h�IE APPLICi <br />AND ADDRPSS. AND AD <br />�:TFiETT 4i� ag::;;.. <br />-1<S?r�i1i49:: <br />PHONE PNONE�. <br />r ,n, <br />TA%PARCELID.��ETAC($;P G,A':�..�E �p��F� <br />D[SCRIPTION OF <br />PPOPOSED WORK� <br />PERMIT CONDITIONS <br />.._,'4;;��Jii� <br />Da�e <br />��,�5._-.::� i <br />Public Work; Permit i(; ,-, r.. �:_, �- <br />Building Pe'mit # <br />Planning Relerence 7t <br />:..P.i . <br />Public Warks Fee S <br />Guarantee 5 <br />t. All calls (or inspection shall be made 24 hours in advance -�hone (425) 257-8810 <br />2. NI work shall be performed in accordance with tliis permit and current City of Everett Design and Construction <br />Slandards and Specilications. <br />3. Call Location Underground Service 48 hrs. be!ore you dig. TOLL FREE NUMBER 1-800•424-5555 <br />,. ._- --..•_i:u�-�z n�,��, r.�-., ,..tL the FubL•c Woi��... ?r.�p�c.... ;F.::1:, S<:5-.,...-.�;0' t�, <br />,� �,..., i.:.,:ntiai or.;:n_n- rr��itin•� ,:n�.i .-r�';i:r -. �nr_rr,i :.r.:r .- I..: :nn�n� 'iv_ ���c. _-_ <br />i A'ppmvcd lor Conslruclion D�t� �/ <br />� . I �� � <br />I � <br />�l : �� jC. I ��`c•: � L - �- � �. <br />FINAL INSPECTION j <br />A�uroved as Const ieU� � Date <br />ACKNUWLEDGEMENT OF CONDITIONS <br />The undersic�ned ownenapplicant hereby agrees to hold and <br />save harmless Ihe City ol Everett from any and all claims for <br />damages. costs. expenses, or causes of action tha� may anse <br />because of installation and maintenance of the impmvement or <br />other nghbobway use hereto applied lor antl furlher agrees to <br />remove same upon noiice Irom ihe City and lo replace public <br />properry damapetl thereby. <br />� <br />L�� 4.l `-� /2/3 <br />SignaNr�Ap anl �Dat �-----� <br />\NORK AUTHORIZ[D E3V TH�S P[RMIT MUSi �E STARTED WITHIN 1B0 DAYS OF DATE PERh11T IS ISSUED AND THEFEAFTER IS t0 BE DILIGENTLV PUFSUED <br />10 COIdPLETION THIS PLf{�,�IT IdAV Hf CANCELLED BV 7H[ GTV UPON ANV SiOPPAGE OF WORK ON THIS PROJECT OVER 90 DAVS Ol1RATION. <br />`W <br />= <br />V/ <br />W <br />O <br />� <br />Z <br />O <br />H <br />� <br />O <br />a <br />