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PUBLIC WORKS <br />PERMIT <br />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 />Planning Reference # <br />Public Works Fee S <br />Guarantee $ <br />-ice l.rHD ET;YIRi1)1MENTAL 37RATE(7 <br />4106 AIRPCI?T WY S, STE 200 <br />EATTLE trn aq g4 <br />PHONE: (PHONE: . w10 1. <br />ITAX PARCEL I.D.# PROJECTADDRESS. TT ^ <br />DESCRIPTION OF - <br />PROPOSED WORK: <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hours in advance. <br />2. All work shall be performed in accordance with this permit and curter' City of Everett Design and Construclion <br />Standards and Specifications. W <br />3. Call Location Underground Service 48 his. before you dig. TOLL FREE NUMBER 1-800.424.5555 <br />c"zs �i yX. K' n, 129 G �c <br />Appro 0 onstruction Date <br />FINAL INSPECVON <br />Approved as constructed Date <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless the City of Everett from any and all clr ^s for <br />damages, costs, expenses, or causes of action that arise <br />because of installation and maintenance of the impr .•nl or <br />other right-of-way use hereto applied for and funht,i agrees to <br />remove same upon notice from the City and to replace public <br />property-dar j ere <br />v "% ^A/I ��30- Ole <br />Signature or�pplicant Date <br />80 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br />TO COMPLETION. ORK AUTHORIZD BY THIS PERMIT MUST BE STARTED WITHIN IPURSUED <br />THIS PERMIT MAY BE CANCELLED BY THE ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. DATAS <br />N. ATABAR.ING. <br />EPWP QRS) <br />