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RUBLIC WORKS Date � - - ( <br /> Public Works Permit q � �'�' '�'�- <br /> PERM 1 T �mlding Permit X <br /> PUBLIC WORKS DEPARTMEN7 Planning Relerence x <br /> 320U Cedar Street <br /> e��ye�en�,4w{�n�sya}z9o��UN 2 5 2UL'1 P�ei�cwo�ks Fee s . :: <br /> T� r�t7 I �IVU.. ....... .............._.... G�arantee5 <br /> OWN6RNA�dE APPUCANTNAME <br /> ANDAUDRESS ��i,, �•�� r��L� ANDADDRESS: y> � uF�'F,' ��f;�: LAHE':'il <br /> 15p� ?ST8 S7' Sk <br /> r'V::P.ETT IU1 . ��..,r. <br /> PHONE' :9'?i_SQ IPHONE'. :_��r"r.�J9�UP I <br /> Y�_ l�_ 7b <br /> TA%PARCELI.D.p PFOJECTADORESS: <br /> ns'1 ,H�fF'`';Y 47v <br /> DESCRIPTION O� <br /> PROPOSEDWORN' STTE 17CFh ['i'. p'i.E�.Ti•.T:`.Al. ;:1�?,:."'>.j'ii��' <br /> PERMIT CONDITIONS � <br /> 1. All calh for inspection shall be made 24 hours in advance. <br /> 2. All work shall be perlormed in accordance with�his permit and current Cily of Everelt Design and Consiruction <br /> Standards and Specifications. ■. � <br /> 3. Call Location Underground Service 48 hrs.before you dig.TOLL FRE[NUMBER 7-800-424-5555 W` <br /> . 'i" .- � . ... ,.� . . .�,I i'; - . . . . , . . - _ , � . - .� .. . . —/� <br /> V♦ <br /> � . _- , . �� . � . . . ' . . (ti "`%Y�a} �_ � O <br /> � � � - <br /> r,�� ' <br /> - ` Z <br /> � <br /> �� � <br /> '_�s��°�'"= V� <br /> � '-= _,�� <br /> � <br /> a <br /> ACKNOW'_EDGEMENT OF CONDITIONS <br /> ��� — The undersigneo:�mei/applicant hereby agrees to hold antl <br /> � '`� Q / save hamdess the Cil oi Everett iwm an and all claims lor <br /> _ �J �/-�.v���^ /�< �. //r�✓ 4� tlamages.costs,expenses,or causes of ciion that may arise <br /> AnPro constmctiw Da�e becTuse ol installation znd maiNenance of the impwvemenl or <br /> ///�� other right�obway use hereto applied lor and funher agrees to <br /> ��th! �ti_ � �b 07 remove same unon notice Imm�he City and lo replace public <br /> FINALINSP 71 N propertxd'aRldxfdthereby. � , <br /> �'� /. <br /> Appmvetl: Conslmcictl alc � ) �( ' _ /'y���,/�,)' <br /> ��:�;%`��=__ - ,i� , t � <br /> ___ S�pr�ure�tApplit.aN Dale <br /> WORK AUTHOFIZED OY TMIS PERMIT MUST DE STARTEO WITHIN Id0 DAYS OF DATE PERMIT IS ISSUE7 AND THEREAFfER IS TO Oc DILIGENTLV PURSUED <br /> TO COMPLETION.THIS PERMR MAY BE CANCELLED DV TNE CITY UPON ANY STOPPAGE OF WORK('N THIS PRQIECT OVER 90 DAVS DURATION. <br /> EP1VP P O!0 brITRBRF.MG <br />