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/ <br /> PUBLIC WORKS Date f `�" ` <br /> Pub6cWorkSPermi�# °L4�'��-�" � <br /> PERMIT BuildingPermit# �"'� � -" <br /> PUBLIC WORKS DEPARTtdENT planninc�Relere.�ce k <br /> 3200 Cztlar Sireet <br /> Everett,WA 982�1 Public Works Fee S ��-� • <br /> (4251 257�g�,0{'�,GS I I�VC.....��N �' 5 ZL' �J Guarantce S <br /> u r ._._._. . <br /> OY✓NERNAId,FJS�lnSTT La'{.'x•�_: APPLICANTNAME M <br /> AND ADURES$:_ AND ADDI7ESS. <br /> YV $��:; i�.[� <br /> F����V:Tl .. . ..� . <br /> � �-v �. <br /> PHONE�. �:-..`�S?'��J':" PHONE� - , � _ - <br /> 7A%PARCf:I.I.D.k � ;;y_y:-�(1_:. _ PROdECTA�ORESS ��N.h <br /> DESCRIPTIONOF 1(T'.i' � - - �' - �/ "�n <br /> PROPOSLD\NORK: "__�. ...... _ . _ . � � OUO I � I f/ / C.W <br /> ' .%�':'I''.C':-�i� <br /> PERMIT CONDITIONS ���- <br /> t. All calls for inspection shalt be made 24 hours in advanre- phone (425)257-Bd10 <br /> 2. All work shall be performed in accordance with tliis permit and current City of Everetl Design and Construction <br /> Standards and Specilications. <br /> 3. Call Location Untlerground Service 4N.hrs.before you dig. TOLL FREE NUMBER t-800-424-5555 <br /> <- J .::11 . 'dR:'3L': .:r..-� [t3f1i1. 1� _C �'^� d31i7' � . -. ... 'll.i 3 : f . . � <br /> � � 1L�J�' _ allii � yl.r. -F2L rr�iilll:l_.. _ ' . � . . ... � <br /> /�/� <br /> . Conn�c* coof and f��ntiny �ica�n, t�: exi>>tin�3 r� SLUIi 3t :. . .tll :,l,i.p .;,j �,� �;pect}��. V/ <br /> . Connect sida sewe Fwi City Standard N's FO1, u02, r,,r;a. ' <br /> ��. �119�`.311 ?L'ODlOIl COIILCQI 10�?3iUC�C j7BL C1L}� oE Ev�c�it :; 13L•:..`. 2 �C :iC,dti p3CC�'i: M <br /> E . Femove ei��si_�n conttol m-rasuces upon c.�:npletion ��f th& } i.��Fcti,}�iit�r t.t� fznal W <br /> �j�pCOVal �>f Lhe peCIr1Y. �: . �• O <br /> . No dict, mud, rocks oc det�eis tc� k�e tracked onto coad�:;;�. � � <br /> s�� . :J_ '.�•,i'_�.:.��; r.s`er_s'se : !:� ;.ra�:-�,� �n ..�_d,�i.,ai>:� an�'_ -;�i��a:ke r�� ba k�apL c]�es:: <br /> : � . _ . .. . . :., . . �^ i`7 Z <br /> Gr�7 . .z O <br /> � ��J .-'�� s>:.:, ;�., � � <br /> e iC.T�t!+ iA !F+ N <br /> nCC•-]�'i����.q�a»� <br /> 1, �, .- O{��[•,1 t-.+_ - � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> �� �fS� / � The undersigned ownerapplicanl hereby agrees to hold and <br /> �. ����nC/<.L-• ���, n � save harmless the Ci�y ol EvereR irom any and all claims for <br /> n iovea ror Cons��ucuon �ie damaoes.costs.expenses,or tauses of action that may arise <br /> /�/� be ?use of installation and maintenance of the improvemen�or <br /> 1 �( �Yi- L t�/�l({A� / c� othr,r righFol-way use hereto applied lor and luriher agrees to <br /> ` (O�6� remove same upon nohce from the Ciiy and to replace pubhc <br /> FIYAL WSPC-CTION p�oper y damaged thereby .7 <br /> Approved as Conslmcted Dalr /�✓ , � <br /> - �> >C�-'Ln, _�—�.�����._ <br /> S�gnatureof Appl�cam�Y �' �--' Date <br /> C10R��<AIJTHOf7171FD fY iHi3 P[Hldl i IdUST PE START[D 1NITHIN 180 DAV$pp DATE PERMIT IS ISSUE�AIJD TNEREAFTER IS TO�E DILIGENTLV PURSUED <br /> 10 C061PL6�ION.IHIS FERIdIT l,tAV�[CANCCLLED RV TH[CITV UPON ANY gTOPPAGE OF IVORK ON THIS PROJECT OVEF7 00 DAVS DURAiION. <br />