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PI�BLIC WORKS Date �_ zy� DI <br /> Public Works Permi�a <br /> PER M 1 T BuilAinp Permit a <br /> PUBLIC WORKS DEPARTMENT Planning Reterencc a <br /> 3200 Cedar Sireet <br /> Everetl,WA 98201 P�blic Works Fee S <br /> (C25)257-8810 <br /> Guar�nlce 5 <br /> OWNER NAME APPLICANT NAME �/� <br /> ANDADDpESS: ANDADDRESS' �/�7UC�/COLC <br /> P.v Box // ��9 n p <br /> PHONE: pHONE: 5�70�OM�I h �L�♦ 7 B2/ � <br /> TAXPARCELI.D.� PROJGCTAD�RESS: 3QZS'�UCi�'¢✓ A✓e. <br /> DESCFIPTION OF A (` J <br /> PROPOSED WORN'. CONT7/�' �r.t/x/„{ JQHC�L�/'�f <br /> �COCk c�l�' Pc?r�Eihy ¢J'�dzc�al,f Q �oi�J �uc,Fei' 14✓2, <br /> P�RMIT CONDITIONS �� f�rtt. � �b � <br /> ff'!/4 <br /> 1. All calls for in�peclion shall be made 24 hours in advance-phone(425)257-8810 <br /> 2. All work shall be performed in accordance with Ihis permil and current Ciry of Everetl Design and Conslruction <br /> Slandards ano Specifications. <br /> 3. Call Location Underground Service 48 hrs. belore you dig. TULI FREE NUMBER 1-800-424•5555 <br /> _ W <br /> ¢ �/�sf4lL S.� c�oC.f �Losee� � / " <br /> 4!7¢wd cs'iJChS G.� '�/� <br /> N� COr.�Er 07` P4 r if, G ./ � /� V/ <br /> 7-� Qur�'cY an�. Tne M <br /> SE. Cnrr,.�r O f� C.c/ril( d' iPu r,Ec r . W <br /> S. .G�7STAL� Trah'rL �'Oh�O� �L/" ��1vTLO O <br /> /�� f�itY 6ro,F��� or �.�nG.1� a �✓ .S'ic%waC� S/�klC �r rePla�ed O <br /> 4f" -f/ic C�ii�G�ioh ei� �!G 4�d �!/GIiG L✓O�^,Er /�S�eC'foI^, <br /> / ` <br /> � ���/(.C�'iC �N13 LUr� �0.„� jH <br /> ad��ct� -I9 �03'}'o{�-cL V� <br /> �S�a.Ll }�ct�r. n�' sa�� AMJ. wc+-1� GInP.c.,, O <br /> G1l(tn-� hld�-N.bw�..c ri��.1' {vins � �u+— �vclr�r �o f a��-�+z <br /> CStc -ftiaP/�Z �a- �)O f K �t,� �u�aC.� w- S�n�) �• <br /> � � � <br /> " � ACKNOWLEDGEMENT OF CONDITIONS <br /> � � y O/ The undersigned ownerlapplicant hereby agrees to hold and <br /> ! save harmless the City oi Everett irom any and all Naims for <br /> pmvea mr Constmcuon ate tlamayes,costs,expenses,or causes o�act�on that may arise <br /> because ol installation and maintenance of the improvement or <br /> other right-o4way usc hereto applied lor and further ag.ecs to <br /> removc same upon notice irom Mie City and to replace public <br /> FINAL INSPECTION prcpe damaged thcreby. <br /> Approved as Conslrucle0 Ddle <br /> Si9wWre ol Applicanl Date <br /> WORK AJTHORI2E0 BY T111S PERMIT MUST BE STAF�TED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTE:1 IS TO BE DILIGENTLY PURSJED <br /> TO COMPLETION.THIS PERMIT MAY DE CANCELLED BY THE Cltt UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVEP.90 DAYS DURATION. <br />