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PUBLIC WORKS '�"�e 11/3/2003 / <br /> PuDlic Works Pertnit M PY0311-001 <br /> PERMITBuilding Pertnit N <br /> PUBIIG WORKS DEPAFTMENT Planning Rclerenco N <br /> 3200 Cedar SVeel <br /> Everen.WA 90201 Public Works Fee E 525.00 <br /> (425)257-BB10 Guaranlce S <br /> OWNERNAMEP�I7.I LEfI�] APPLICANTNAME <br /> ANDFDDRESS ' ANDADDRE55�. <br /> 1801 Madisun Stceet <br /> �TT iU4 98203 <br /> PHo�E, 4253535398 PMONE: <br /> TA%PARCELI.D.t PROJECTADDRE�S�'{O3 ilefiore 1lvenue <br /> DESCHIPTIONOF Replace Side�alk <br /> PROPOSED WORK' <br /> PERMIT CONDITIONS <br /> 1. All c�lls for inspection shall be made 24 hours in advance •phone(425)257•8810 <br /> 2. All work shall be performed in accordance with Ihis permit and current City of Everett Desiyn and Conslruction <br /> Standards and Specilications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 � <br /> 4. Side�alk shall be as pec city of Evecett Standard Plan Mt06. � <br /> 5. Keep city ateeet� cl.ean at all r.imes during consteucti��n. � <br /> 6. Call the puDlic vor.ks inspector p 339-7403 pr�ioi R� t�eg�nnfng consteact_ion. r� <br /> W <br /> O <br /> 11-03-03 12:OBFN ' <br /> p 0311001 <br /> OTHcR 25.(� Z <br /> TOTAL 25.00 C ] <br /> CASH P�0 <br /> A (k15239 �'A <br /> vI <br /> O <br /> a <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> I I — � �� The undersigned ownerlapplicant hereby agrees to hdd and <br /> ,���G�� save harmless tho Ciry ol Everefl irom any and all claims Mr <br /> npprrnea br svu j oa�e damagas,casts,expenses,or causes o�ecpon that mey arise <br /> j because ol installation end mainlenanca of Ihe imprwement or <br /> other righ4ol•way use herelo applied for and lurther egrees to <br /> �( /� -/�-U 3 remo e same u notice irom tlie Ciy and to replace publk <br /> FINAL INS CTtON pr .d m lho <br /> ' �1i ,3� 6� <br /> qpprpvetl as Conslruttcw Date . <br /> r <br /> SignaWre ot M{�p �� Date <br /> T+O COMPLETOION TM SrPERM T MAY BE C NCELLED BV�THE CI7V�UPON ANVOSTOPPAGE OF WORK ON THIS PRQIEC OVER 90 OAYS I�'AE�NPURSUEO <br />