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/ <br /> PUBLIC WORKS Date <br /> Public Works Permit p � <br /> PERMI T Buildmg Permit# <br /> PUBLIC WORKS DEPApTMENT planning Relerence k <br /> 3200 Cetlar Stmel <br /> Everetl.WA 98201 Public Works Fee S <br /> �az7sizs�n-ea/i{o�7T �1 ��UV 0 4 2007 <br /> lo fU'UIIN47:.-...::,:...........�— Guarentee5 <br /> OWNER NAME APPLICANT NAME <br /> PNDFDORESS: - ANDFODRESS: <br /> PHONE: PHONE: <br /> tA%PARCEL I.D.N PR0.IECTADDRESS: , . _ _ , <br /> DESCFIPTION OF . . . . . . <br /> PROPOSED WOflK: � <br /> PERMIT CONDITIONS <br /> 1. All calls for inspeclion shali be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construc;ion <br /> Sta�idards and Specifications. � <br /> 3. Call Location Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800-424-5555 ` <br /> r <br /> '�A <br /> . . . . . . .. . . . . . . V/ <br /> W <br /> O <br /> � <br /> Z <br /> O <br /> F- <br /> � <br /> O <br /> a <br /> — ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned ownar/applicant heroby agrees to hold and <br /> L�� _.r`^�. �' ,� ,' J save hartnless tha City of Everetl trom any and all claims lor <br /> Appr lor Cansimceon oa� damages,cosls,ezpenses,or causes of action ihat may nrise <br /> � because�� stallation and maintenance ol Ihe impmvemen�or <br /> �j��_ /�— zz—07 othe�ng o-way use hcreto applied lor and IuAher agreas to <br /> C—��(��.- � removU! e upon notice irom Ihe City and to replace public <br /> rINAI INSPE�ON propep tl ihereby. -- <br /> ' Arpmved as Lonslrucled Date �, ^� <br /> ISignaiu olAppliCanl ✓Uaie G� <br /> l'JOIiK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITNIN 1800AVS OF�ATE PERMIT IS ISSUED AN�THEREAFTE�IIS TO UE DILIGENTLV PURSUED <br /> 70 COMPLETION.THIS P[RMIT MAY OE CANCELI.ED OY TH[CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAVS OURATION. <br /> 'P,�i'i;OGI DRTA9AR.INC. <br />