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"_ ��� PUBLIC WORKS PtRMIT <br />City of Everett Public Works Department <br />3200 Cedar Street <br />��, � �`Z Everett, WA 98201 <br />(425)257-8810 <br />Oate: <br />Pubiic Works Permit #: <br />[3uildinq Permit #; <br />Planninq Reference #: <br />Public Works Fee 5: <br />nther $ <br />OWNER NAME AND ADDRESS: APPLICANT N�ME AND ADDRESS: <br />THE EVERETT CLINIC COMMUNITY TRANSIT <br />3901 HOYTAVE <br />EVERETT WA 98201 <br />PHONE: 4252591163 PHONE: 4253487100 <br />TAX PARCEL ID # 00411300501300 SI7E ADDRESS: 3929 RUCKER AVE <br />DESCRIPTION OF PROPOSED WORK: <br />BRT STA'TION - THE EVERETT CLINIC <br />STATION # 2819 40th ST. AND EV[RGREEN WAY NORTH BOUND <br />9/11/2008 <br />PW080�•012 <br />6Q809-02G <br />5 45.00 <br />PERMIT CONDITIONS <br />1. AII calls for inspection shall be made 24 hours in advance. <br />2. All work shall be pertormed in accordance wilh the pennit and current City of Everelt Design and ConsUuclion Standards <br />and Specifications. <br />3. CaII Location Underground Service 48 lirs before you dig. TOLL FREE NUMBER 811 <br />4. CONSTRUCT PER PLAN <br />Lzl <br />E� <br />�. <br />� <br />G� <br />� <br />ti <br />z <br />0 <br />� <br />� <br />0 <br />a <br />� <br />��� �i. /O-l2-o� <br />�-= <br />INSP6�TION Dale <br />aed as Construcied <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner(applicanl hereb} agrees to hold and <br />save liarmless ihe City of F.verett from any and all claims for <br />damac�es, cosls, expenses, nr causes of ac�ion Iha� may arise <br />because of installation and uiaintenarce of ihe improvemenl <br />or other right-of-way use h�reto applied for and furiher agrees <br />to remove same upon notice lrom Ihe Ciry and �o replace <br />public property d nlaged there y. <br />jA /2��Uf� <br />Signature of Applicant <br />Dale <br />WORK AUTHORIZED �Y TH;S PERPIIT P1UST QE STAR7ED \i'ITHIN I60 DAYS OF DATE PERPIIT IS ISSUED AND l"HEREAfTER IS TO �[ DILI6EPl1LY <br />PURSU[U T' COFIPLETION. Tf11S P[RP1R F1AY O[ UNCELLEU 6Y TNE CITY UPON ANY STOPPAG[ OF PrORK OP: 1 H6 PROJLCI O\'ER 90 DAYS DURJ+iION. <br />