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Date ,s ; I <br /> PUBLIC WORKS Public Works Permit# PW070 2eo4 <br /> PERMIT Building Permit# <br /> PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street Planning Reference# <br /> Everett,WA 98201 Public Works Fee$ <br /> (425)257-8810 •0 0 <br /> Guarantee$ <br /> OWNER NAME APPLICANT NAME <br /> AND ADDRESS: .R DDAS T.,?;Y , AND ADDRESS: <br /> -- <br /> L 7->_ 1]e,TH PI.. SE <br /> PHONE: ^r; 1 t r;` PHONE: <br /> TAX PARCEL I.D.# m ' )+ PROJECTADDRESSfi <br /> DESCRIPTION OF a aT r,Ts �” ;Yr:i <br /> PROPOSED WORK: <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. Remove tree <br /> r tt {r .. 7 .p.'i n3idewalk and _.r a t ..:.J'__i Imm <br /> . Traffic ....:?T;:-... i.C... currant WJTCD Standards <br /> 0 <br /> z <br /> 0 <br /> I- <br /> CO <br /> 0 <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and <br /> Raw \ � 4" 5 100 save harmless the City of Everett from any and all claims for <br /> .rove. or Con ru.ion bate damages,costs,expenses,or causes of action that may arise <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 /> FINAL INSPECTION pro erty damaged thereby. <br /> Approved as Constructed Date <br /> i -2,l3-Q? <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 BE 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(7/06) DATABAR,INC. <br />