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Dete 8/2/2001 <br /> PUBLIC WORKS PwoloB-oo4 <br /> pubNc Works PamW II <br /> PERMIT ��PB��« <br /> PUBLIC WORKS DEPARTMENT Plannirq Relerenca II <br /> 92op Cedar Street $40.00 <br /> Everett,WA 98201 Public WoAcs Fee S <br /> (425)257•8810 QuaraMee S <br /> OWNEPNAME APPLICANTNAME ar an 2 <br /> ANDADDRES539O1 Hoyt AV2 ANOADDRESS: <br /> EVERETT WA 98201 <br /> PHONE: ( 425)258-0966 PHONE: <br /> TAXPARCELI.D.� PNCUECTA�DRESS: pOleS <br /> DESCRIPTIONOF ns a opper an r p c ines e ween �ampuses <br /> PROPOSEDWOFiN�. �1 � y .�0� �Gr$,r/�yG <br /> Pw ohod e�h� b;�`A' IZcvtc►'�1zP <br /> 5�G <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection s'�all be made 24 hours in advance•phone(425)257-8810 <br /> 2. All work shall be perlormed in accordance with Ihis pertnit and current City ot Everetl Design and Construction <br /> Standards aM Specifications. <br /> 3. Call Location Underground Service 4B hrs.belore you dig. TOLL FREE NUMBER 1-800�12!•5555 � <br /> 4 . As per the terms and conditions of the "City of Everett Public Works � <br /> Revocable General Permit For Activity Within The Public Right-of-Way" <br /> Labeled with the Permit Number PW0108-004 . 'A <br /> \// <br /> W <br /> O <br /> � "'Pi ' <br /> 1 /��/� , .. :�c,n oa Z <br /> 4 GG <br /> `��,r�y �1 _ _ �.. O <br /> �v� -, � � ,._ _ <br /> ' L I i'.'_ � <br /> � <br /> � , a <br /> l�r <br /> ���P <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ¢� The uMersig�ed owner/appUcent herebY e9rees to hdd end <br /> —2—V` seve harmless the Ciry ol Everen from any a�d elt clalms lor <br /> Appmved for Conswciion Da�e tlameges,costs,ezpenses,a causes ol ecibn that msy edse <br /> because of instellebon and melntenence of the Improvement or <br /> other Nghtol•way use hereto applied for end IuMer egrees ro <br /> removo same upon nedce Irom the CNy end to replace public <br /> �INAL INSPECTION propa� aged thereby. _ <br /> ApproveA as Constructetl Date ���_� � <br /> re ol Applicant Dels <br /> �O CUMPLETOION.ETIiIS PERM T MAY BE CANCELLED BY�T E CIT'�LPON ANYOSTO PAG OF WORK ON 1HI5 R0.1EC OEVER 90 DAYSWMTION.�SUED <br />