4102 RUCKER AVE SWIFT 2016-01-01 MF Import

,n �� � �:�rf,:J�'(T PUBLIC WORKS PERMIT City of Everett Public VJorks Department 32D0 Cedar Street Everett, WA 98201 (425)257-8810 Date: Public Works Permit #: Buildinq Permit #; Pianninp ReFerence #. Public Works Fee $: Other $: OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: SAFEWAY INC #443 COMMUNITY TRANSIT 1371 OAKLAND BLVD STE 200 WALNUT CA 94596 PHONE: 5106653934 PHONE: 42534871J0 TAX PARCEL ID # 00582101402502 SITE ADDRESS: 4102 RUCKER AVE DESCRIPTION OF PROPOSED WORK: BRT STATION - SAFEWAY #443 STATION # 7.820 41sLST. AND EVERGREEN WAY SOUTH 130UND 9/11/2008 PW0809-013 ' 80809-027 5 45.00 PERMIT CONDITIONS 1. All calls for inspeclion shall be made 24 hours in advance. 2. All work shall be perfonned in accordance with the permit and current City of Everett Design and Conslruction Standards and Specificalions. 3. Call Location Underground Service 48 hrs hefore you dig. TOLL FREE NUMBER 811 � 4. CONSTRUCT PLR PLAN. w � wr � � � � z 0 F � O a �CKNOWLEDGEMENT OF CONDITIONS The undersigned ownerlapplicanl hereby agrees to hold and save harmless the Cily of Everetl (wm any and all claims for damages, costs, expenses, or causes ol action Ihat may arise bec�use ol inslallation and main�enance o( �he improvemenl ur olher right�of-way use hereto applied for and further agrees to remove samo upon notice (rom the City and �o replace public property dai aged her y �.�� iz//'� Sic�naturc of Applicant Date WOHY, AUIIIUItIlI-U li�f II11': I'I Rt41I t1USl Hf ti1�AItIt I� 171IHII! If�U UAYS OI� DA1f� PI:Rhi1T IS ISSU[D APlD THCR[AFTER IS TO OE �ILIGf:FIILY PUItSU[U IU C014PI I I ION. IIII'� I'I It411I 14A'i BI C;J:t I I I I I� 8Y I111 �_I IS UPO�! nNY' Si�OPPAG[ Of VVOItN ON THIS PPOJI_CI OVHi 90 UAYti UUIU1l01l.