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PUB�ic woRKs <br />PERMIT <br />OWNER NAME G <br />AND A�DRE55: 1. <br />G <br />PHONE. <br />TA% PARCEL I.D. N <br />DESCRIPTION OF <br />PROPOSED WORK: <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Slmet <br />e��r�n, wn sazoi <br />(425) 257-BB10 <br />- --------- - --- --� __ ._ �r <br />—_ . .. . _ . _�.__... _�..�: <br />Date I�ylls��Z <br />„ <br />Public WorNs Pcrmit a <br />Builtling Permit a <br />Planning Rcicrencc a ` � <br />Public Works Fec S <br />N G <br />Guaranlee 3 <br />VCCG � SU��nn�h ��,,,r' APPLICANTNAME <br />�Z J �QV�� �VG ANDADDRE55: <br />;re-4� N/A � � Z�3 <br />PHONE: <br />PROJECTA�ORESS'. �/.,�� ��nJ /�V� <br />U/ V �-\ <br />Pl a�cc �z�r ��� d�w►p�r,✓ �� � �Z� Jr�t ��v� <br />— v�� -�t> I✓Y�Oh-i'h �rl Cov1�UnC���Ov� wi�h <br />(�,v ; � d� no� 17fir n`l ;�� G02 CQ- OI 4- <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hours in advance • phone (425) 257-BB10 <br />2. All work shall be performed in accordance wilh ihis permit and current Ciry of Everetl Design and Consiruction <br />Standards and Specificalions. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />4. P�vv ��� � ��,��o �r � a�e f�-� �e ��a�s�core�s � <br />��12,Ce 75 <br />FINAL INSPECTION <br />Appmvetl as Constmcled Oale <br />C fUS� Ti S-�ezs i�'�'0 c�r �, <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownerlapplican� hereby agrees to hdd and <br />save harmless the Ciry o1 Everett irom any and all claims for <br />damages, costs, ezpenses, or causes ol action that may arise <br />because ol installation and maintenance oi the improvement or <br />other nghtof-way use heroto applied for and fuMer agrees to <br />remove same upon notice imm the City and to replace public <br />property damaged thereby. <br />Signalure olApplicant <br />Dale <br />WORK AUTHORIZED BV THIS PERMI f MUST BE S7ARTED WITHIN 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PUFSUED <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLEO BY THE CITV UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />H <br />� <br />m <br />O <br />� <br />Z <br />O <br />H <br />� <br />O <br />a <br />