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PUBLIC WORKS PERMIT <br />� Cdy of Everell Public Works Department <br />� � L�_,�,,, 3200 Cedar Street . <br />Everetl, WA 98201 <br />(425)257=8810 <br />OWNER NAME AND ADDRESS: -��.���' �� I APP�IC, <br />SHEFLO JIM <br />A319 S 4TH <br />EVERETT �n/q 98203 <br />PHONE: 4252522514 <br />'AX PAFCEL ID # 00500400i02300 <br />DESCRIPTION OF PROPOSED WORK: <br />FENCE IN R-O-W - 16' LONG, 42" HIGH <br />Date: 11/12/2009 <br />Public Works Permit #: PW0911-023 <br />Buildinq Permit #: <br />� Bfanninq Reference #: <br />� � P�blic Works Fee $: $ 25.00 <br />. �; I OWNER ; <br />PHONE: <br />Other S: <br />AND ADDRESS: <br />SITE ADDRESS: 4319 S 4TH AVE <br />P[RMIT CONDITIONS <br />i All calls for inspeclion shall be made 24 hours in advance. <br />2 NII work shall be performed in accordance wilh the permif and current City of Evereit Design and Consiruchon Standards <br />and Specifications. <br />3 Call Location Underground Service 48 hrs betore you dig TOLL FREE NUMBER 811 � <br />4 Property owner will have to remove the fence at his own expense if the City needs to work in the nght-of-way <br />YOUR INSPECTOR IS RANDY HLL[N -425-339-i403 <br />;,ted <br />// •/3�C <br />Date <br />ACKN01h'LEDGEMENT OF GONDITIONS <br />The undersigned ownedapplicant hereby agrees lo hold and <br />save harmless the Ciry of [verelt from any and ail claims for <br />damages, cosls. ezpenses, or causes of adion lhat may arise <br />because ol installation and mainlenance ol �he improvement <br />or other right-o6way use hereto applied for and furiher agrees <br />to remove same upon nolice from the City and to replace <br />public property damage�l Ihereby. <br />;� /2-- I I -�/ � � � <br />, <br />Date ' �i�„ � ��c,{ l�- 1�� /�'�� <br />Signeture of Applicant �� Date <br />/ <br />U'ORK AUTNORIZED BY THIS PERMIT 1•1U5T U[ STARTED 11'ITHIN I80 DAYS OP UATE PERDIIT IS ISSUED AND TNEREAf-TEH IS TO 9E DIUGENTLY <br />i'URSUFU TO COhIPLEIION. THIS PERMIT F1AY 6E CANCELLED 6Y THE CiTY Ui�DN ANY STOPPAGE OF \NORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />