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� <br /> � Date '�lj�i_-�if:7 <br /> P����� ����� PublicWorksPermit= '-�'''�?''�-'.'��-: <br /> PEi31V11 T Building Peimit�1 <br /> PUBLIC WORKS DEPARTMENT Planning Reference« <br /> 3200 Cedar Street <br /> Everelt,WA 98201 Public Works Fee S ;� � i��� <br /> (425)257-8810 `... . . <br /> Guarantee S <br /> OWNER NAME APPLICANT NAME I <br /> ANDAD�RESS: p_t�,C Ncb713Rd ANDADORESS: E+eteC Newland <br /> P.O.Eex 5959 Y.�!.Box 5459 <br /> Evetett Wa 98205 Evecett Wa 98206 <br /> PHONE: � � c� � 5 PHON'c: ��S?S�QASS <br /> 9�5�5. 415.- <br /> TAICPARCELI.D.# PR0.IECTAODRESS: <br /> �410 38th 9t <br /> DESCHIPTION OF ` I <br /> PROPOSEDWORK: PUt 1O � !'RIIC� 3' E3�C PR� Ci ?E�tFl 9t. k.O.F': il <br /> PERMIT CONDITIONS <br /> 1. All calls lor inspectien shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with this permit and current City of Evereq Design and Conslruction <br /> Standards and Speci(ications. � <br /> 3. Call Location Underground Service 48 hrs. belore you dig.TOLL FREE NUMBER 1-800-424-5555 <br /> 1. �onsC[��,_r p��_ �k_-•-h '�^ <br /> V/ <br /> :.� � <br /> _ � <br /> � <br /> _� L <br /> ��i (� O <br /> �i� . �w <br /> � '� <br /> ��� �I <br /> 1 � I1 <br /> "l 1 � � <br /> H _ <br /> �_� .f. � <br /> �1 <br /> � � ACKNOWLEDGEMENTOFCONDITIONS <br /> _ _.--,=-� .._. _ �� The undersigned owner/applicant hereby agree�fo hold and <br /> -��"-��- - �- �1'� / ��-7 G;,� save harmless the City ol Everett from any and all claims tor <br /> ;�a�v d lor ns�m ion Daie — aamages,costs,expenses,or causes of action�hat maV arise <br /> because of insiaiiaiion and maintenance of lho improvemenl or <br /> % v� � other righ�- (way use ereto applied tor and luriher agrees to <br /> '� remr��e sAmewpon no ice from the City and to replace public <br /> F AL INSPECTION p�OPgrty am�ed iher by. � <br /> Appmvetl as Consimctetl Oa:o � <br /> ' -' z`fi�,�'- �-_7�'�_}- <br /> SignaWreolApplicant Date <br /> V:OFiK AUTHORIZE�BYTHIS PERMIT MUST 6E STARTED WITHIN 18G DAYS OF DATE PEFi1AI71S ISSUED AIJD THEREAFTER IS TO 9E DILIGENTLY PURSUE� <br /> TO COMPLETION.THIS PERMIT MAV�E CANCGLL6D BY THE CITV UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVEA 90 DAVS OURATION. <br /> CP49P(]lOfil DAlnl3'�R R:C <br /> __—_'_ . _ . _- __. _.....�lf' <br />