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P��i�'V �V��V Date . -� . - :.. /: <br /> PubliC WOrks Pemai = <br /> PEIRMIT a���d��g PF��:,� : <br /> PUBLIC WORKS DEPARTMENT Plannin� Refe�:cn�.>., �� <br /> 3200 Cedar Sireel - � � � • <br /> Everelt^UM JAN 2 Public Works-. F�..,. ; <br /> �azs�zs�-4e,�o��IIU'lj 2 2006 <br /> ��_� Guarantee S <br /> p ' � � <br /> OWNEFNAML APPLICANTNf+ME 1302$ 93C1?oi' ii.�:�,;!7" <br /> AND ADDReSS' AND ADDRESS: � " '-�''�� <br /> MtJ}CZLTEO '?r. 98=iS. <br /> 4i567i11'136"v <br /> PHONE FHONE: <br /> . t : <br /> TAXPARCELI.D.a - PROJECTA�DFE55� � <br /> ��6C1Z0:1 i:::elillll�. F3C1_lt}' <br /> DGSCRIPTION OF <br /> PROPOSED WORK�. <br /> I — <br /> PERMIT CONDITIONS <br /> 1. All calls for inspeotion shall be made 2a hour in advance -phone 14251 25'-8810 <br /> 2. All work shall be performed in accordance with tYiis permit and current Ci(y of Lverett Des�gn and Constructior <br /> Standards and Specilications. <br /> 3. Call Localion Underground Service 48 hrs.before you dig. TGLL FREE NUMBER 1-800-424-5555 � <br /> . A� pec spk�iu�,e�9 plan date�9 L:i-il-p5 and th�� publi�� �:L::a :n_F:�_to� 's :?icecti�;; :n <br /> ��h= ii.«l�i. � <br /> r.. ;yali� DOI�.,.> :..'.3't1 t�.. �ifrC:i.'C i 1f.:!ilTU!!: �=�f . _c_v. fC:�C: `-.'1� _c���_.r:lll? ^. s 'i.@ �1C:: <br /> . � <br /> ' I' '" -`'"+_ '" "....: :LC_ , ... _.._.. .: . _ . . � <br /> W <br /> O <br /> � <br /> Z � <br /> O <br /> H <br /> � <br /> O <br /> � <br /> ACKNOWLEpGEMFNT OF CONDITIONS <br /> ,����•��� / l � The undersigned owner/applicant hereby agrees Io hold and <br /> �� "'Y(10 �t„/—� I�U save harmless Ihe City ol Evereu fmm any and all claims for <br /> � l J�i <br /> pmvc9 ior Construcond Date damages,costs,ezpenses,or causes of action that may arise <br /> � t 6ecause oi installation antl maintenan:e of the improvement or <br /> r . � I� . �. � other right-obway use hereto applied lor and furlher agrees to <br /> ��`� �� � ��`'� ' �, < 1"t • remove same upon notice irom the Ciry and to replace public <br /> FINAL INSPECTIOW � prope damaged th by. <br /> Approved as ConsVuc�eo � Date <br /> __ �'��� O ��Q� <br /> nalure of ApplicaN D� <br /> WOFK AUTHORIZED BV TNIS PERh11T 1,1U5T BE STAHTED WITNIN i00 DAYS Of DA7[P[RL117 IS ISSUED AND THER[AFTER 1570 BE�ILIGENTLI PUfiSUED <br /> TO COWPLETION.THIS PEFAIIT 1.1AV�G CANCELLED BV THE CITY UPON AHV STOPP.:GG OP WORK ON THIS PROJECT OVEP.90 DAYS DURATION. <br />