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PUBLIC WORKS ( Date g��7p03 <br /> �� ,�-"" � <br /> �� _ .�,�,y� Public Works Permit K pQ�yy�U12 <br /> PERMIT ���'- � <br /> Building Permit p <br /> PUDIIC WOAKS DEPARTMENT Planning Relerence a <br /> 3200 CeOar Street ��p <br /> cver�tl,WA S"20' P(,(��fjVU-�Z�{ Public Works Fee$ $25.00 <br /> (425�257�Bi�10 <br /> GuaranteeS a5�� <br /> OWNERNAME BALDWIN L?f2F2Y APPLICANTNAM[ ghLppIpd£f€��FN� <br /> ANDADDRESS'. 3206 iiAVE Dk A�dDADDRESS� $�ME <br /> EVERETT QA gg203 <br /> rnorve: 4253537289 PHON[. <br /> TA%PARL[LID.� OOS�Z�UOSOO�UO PROJECTADDRE55: f;.!I�b it1�VE DR <br /> PROPos�owoRK. CONSTkUCT l� RETP.INING fiALL , . ' � <br /> � �erPer�i[v�41— Qn� J)hp�'r�c�fn�, {ht0 �ft �rS,'�'^ ^ i,J1'l <br /> AC.�kK IN � IGHT C.�F YA PLA. " "a P UIkT AY <br /> P �U^aLY AT , 'rp'(ZC,iN.�IS Wp , , IN�EU 1Y.y�yg pN <br /> r • r <br /> PEFiM1T CONDITIONS <br /> 1. All calls lor inspection shall be made 24 hours in advance • phone (425)257-8810 <br /> 2. �II work shall be periormed in accordance with Ihis permit and current City ol Evereu Design and Construclion <br /> Slandards and Specificalions. <br /> 3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-B00-424-5555 <br /> 4. Woc�C to be ne as direct�c! in the lktter to the ap li�.ant dated 9/15/03 and per W <br /> the 'A��lan r.k De.ign" manua , r <br /> 5. The .r is rFspunsiGle f��r ntaining this impcovF srtit tc� the existiny dict w <br /> valkva� � tween the tw e«a�i-en�i . �,-rion� of Wave Dc. V� <br /> 6. If/the ity evec needs to use t 's area foc aunicip'al p epases then the uvnee is � <br /> L'�?qUlted ti7\CP_mpVN C�1�3 10(7C�JV���I1C9 �lS 1f19iCUCtN�j by th� r1r,y. O <br /> / / � � . 7� � <br /> ,,� ��,j�.,�C 7l1 J�� C�''x �" �� T�rne -� � 2GY�s �co- /"c��--� Z <br /> ri�,:� C�c.�S��> �� Geo fes��Su-�viceS� ThG. � <br /> � <br /> ; -� ' f 1 ��-�;'-� �lohs �172 `�oj-'`h � <br /> C�ii� ro-C 6�vs� f� � <br /> C��� �� � (,lM��i� ny d`f ��de,�o; QCluse, �r , a <br /> ��- v.c vs' /� � _ <br /> ; %��><��� �,v'���h ;�fi� �v�l:� I.JUr',f'�� /i7�e C�v r p!� S� '� <br /> ' (;,,/;dr-; S'r�,- .c,;.,� �J�„-C- -!v d�SCl�ss hd�� �r i.�fa -�/,� <br /> %•'' '-�`�: L-(w!C?:!-f/�L l l!'il� �bl9 �tp�r�d�', ACKNOWLEDGEMENTOFCONDITIONS <br /> �/� CJ The undersigned owneUapplicant hereby agrees b hold anA <br /> '�(J[� � —�r*.� ----/����Q� save harmless the Ciry ol Everen from any and all clalms lor <br /> + .. <br /> p �ea�o�Consimci�on Da �— damages,costs.ekpenses.or causes ol action that may arise <br /> because ol mstallation and maintenance of the improvemeM or <br /> other righbol�way use hereto appGed lor and lurther agrees lo <br /> iemove same upon nonre�wm ihe Clty antl w replace public <br /> FINAL INSPECTION property damagee thereby. <br /> Approve0 as Conslmcted Dale <br /> S��naWre ol Applicant Daie <br /> WORK AUTHORIZ[D 0\'THIS FGRL11i IdUST�E STAI7TED IVITHIN f BO DAYS OF DATE PFRMIT IS ISSUED AND THEREAFTER IS TO DE DILIGENTLV PUPSUED <br /> TO COfdPLETIOtd THIS PE/ih9T 61nV OL C�NC[LLGD UY TH[GTV UPON ANY STOPPAG[QF WORK ON TMIS PROJECT OVBR 90 DAVS DURATION. <br />