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PHONE: <br />PUB�ic woRKs <br />PE�MIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />FIRST 8J1P1TST CHURCH OF EYf <br />1616 P1ICIFIC <br />EVERETT Yr 98201 <br />4252599166 <br />TA%PARCELIA.� 00439173801500 <br />PROPOSED WORK' ���ES FC�Fi YC��iIH FIIEEETIIIGS <br />PERMI7 CONDITIONS <br />PHONE: <br />NAME <br />Da� <br />Public Works PermM N <br />Buildmg Pertnit N <br />Planning Refereoce � <br />Public Works Fee S <br />Guarantee S <br />04i25/2003 l <br />PY0309-039 <br />C0304-018 <br />1. All calls lor inspection shall be made 24 hours in advance • phone (425) 257•8810 <br />2. All work sha�l be pertormed in accordance with this permi� and current Cily ol Everelt Design and Conslruction <br />Standards and Specilications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-000-424•5555 <br />$25.00 <br />4. RF?lOVE EXIS1'IHG 115PArLT IN H�ADICIIP PAWCIIIG ]1RE'.At REC.'W4�E 11M1 RCPIIVE Pi1ii 11 <br />MINIMIAI 2" 7HIC1(NESS QF' CIJ�SS 'B• ASPAIILT. <br />.��.� �a�. . 9 z s � .� <br />AppmvMbr 'nsiruceon Dale <br />-,�-�1� -7���- <br />FIN L INSPECTION <br />Aprroved a5 C0051NCI¢d Date <br />!D <br />iid CK <br />�� !IG <br />c.-: <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />�,A <br />V/ <br />W <br />� <br />� <br />Z <br />O <br />H <br />� <br />O <br />a <br />The urMersigned owner/apptican� hereby agrees to hdd and <br />save harmless the City ol Everetl from any and all claims for <br />damages, costs, expenses, or causes of action that may arise <br />because of installation and maintn�noe ol the irtprovement a <br />other right-of•way use hereto applietl tor end further agrees to <br />remove same upon noNce from the Ciry and to replace public <br />pr�erty damaged thereby. <br />/� /� f'-// =o? <br />Signat eolApplicaM Date <br />WORK AU fHURIZED BV THIS PERMIT IdUST BE STAPTED WI7HIN 18� D�'/S OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGEN7LY PURSUED <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY TH[ CI7V UPON ANY STOPPAGE OF WORN ON 7HIS PROJECT OVEfi 90 DAYS WRATION. <br />