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: - PUBLIC WORKS PERMIT <br />City of Everett Public Works Department <br />" 3200 Cedar Street <br />Everett, WA 98201 <br />(425)257-8810 <br />Date: <br />Public Works Permit #: <br />Building Permit #; <br />Plannirg Reference #: <br />Public Works Fee $: <br />Other $: <br />OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br />MURRAY LEESA KAY OWNER <br />33i0 RUCKER AVE <br />EVERETT WA SBZ�� <br />PHONE: 4252582014 PHONE: <br />TAX PARCEL ID t! 00437578802700 SITE ADDRESS: 3310 RUCKER AVE <br />DESCRIPTION OF PROPOSED WORK: <br />INSTALL CONCRETE PAD <br />611 /2012 <br />PW1206-001 <br />$ 25.00 <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hours in advance. <br />2. All work shall be perfcrmed in accordance with the permit and current City of Everett Design and Construction Standards <br />and Specifications. <br />3. Call Location Underground Service 48 h�s be fore you dig. TOLL FREE NUMBER 811 � <br />4. As per approved plan dated 6-25-12. <br />Your p�blic works inspector is Randy Allen. Please call him at 425-339-7404 to request a site meeting prior to <br />beg�nning construction. <br />�Z <br />A�proved for Construction � uace <br />GI�FF t�uqm� 7-s-��- <br />FINAL INSPECTION Date <br />Aooroved as Constructed <br />W <br />H <br />� <br />� <br />� <br />►'� <br />z <br />0 <br />H <br />� <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownedapplicant hereby agrees to hold and <br />save harmiess the Cily of Everett from any and all claims for <br />damages, costs, expenses, or causes ot aclion that may arise <br />because of installation and maintenance of the Improvement <br />or other right-of-way use hereto applied for end fuAher egrees <br />to remove same upon nolice from the City end to replace <br />publ!c property damaged ihe:eby. <br />of Applicant ( / Date <br />