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� ' <br /> . PUBLIC WORKS Datc l�icb/2003 <br /> Public Works Permit p FWO�1.C-019 <br /> PERMIT "''1'-"15 <br /> Building Permit k <br /> PUBLIC WORKS DFPARTMENT Planning Reference p <br /> 3200 Cedar Strect �:y,��i <br /> E(425)'157.�,8810' DEC 2i 2i ZO �Q Public Works Fce 5 <br /> ,b �QSTiri� �-- GuaranmeS <br /> _ .��_��:::�- — <br /> OWNER NAME �� APPLICAtaT NAME <br /> ANDADDRESS'. �xV� t1FPEF: F:IG�E i:L ANDADDR[SS: <br /> ES'EF.ETT 477: a62fi= <br /> �J2535=9r.�1� <br /> PHONE PHONE: <br /> TA%PARCELID.a ' " " ' ' ' ' PfiOJECTADDRESS:rt'�� ` '' '' <br /> D[SCRIP7IUN OF � <br /> PFOPOSED WORK: <br /> . _ ... _.. .... . . _ .. . . ' 21 <br /> PERMIT CONDITIONS FLF:T <br /> 1, q!I calls for inspection shall be made 24 hours in advance - phone (425)257-8810 <br /> 2. All work shall oe perlormed in accordacce with uu�,ermil and current Cily ot Everelt Design and Construction <br /> Standards and Specifications. <br /> 3. Call Location Underyround Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br /> �. ('.i�IlIU3CL COOt-1�,p�J dlli] OY_�1P_� �jt'd.1IL3t]t_ [p �3kl�i ltlq �7d7:Cf1 �]::�.11t`dAi(rl_�jfy (�Cj�]�'[M1t.}' ��EF W <br /> dCt3,•hBil �rh8ct) . �,i l,'.?..;_'i11.`� <br /> 5, pv pot damaye tl�� �=;cistiny sto[m ii�airi pipe Lhat cun_ sl%�ng 3r�ie,:��t:iti3di6' of the � <br /> pLop:_�tY• _�J:J_I. :".'+C 1;. � <br /> �,. r:mn'act �i 1 sFw_� E�r Ci'y Stan9scd� 601, 6i�� d np9. r' �-;i;, <br /> � . YdV'r �IiV�'V:i�f YCPifi tll� ICC•Ili �.�����@C1 }' Z117e_ �.IJ1 i�? t.Il�� :i1:L �-G'�iiy�.V111U ,_ jj m <br /> �_i�l.�[_ :� ,�t� O <br /> ;_::;��hl.? 4,`:ii/ <br /> ,t o�.oia-, � <br /> ��;;��h �o,�c� Z <br /> �JT�:I.I.�f'i 15fi.(1q � <br /> 'ou7cFi 8O0:':14� <br /> �i i'. . �:�7"',�+.`i <br /> _;.i !�- ; ,. i`i�:': <br /> r � '.'rd�,i:_ //� <br /> V� <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> if � / � The�ndersigned owner/applicant hereby agrees to hold antl <br /> l� d"(�' Y � `� �- save harmless the Ciry of Everen from any and all claims lor <br /> �nn�ove �ur C �mci�on/-, Daie damages,cosis,expenses,or causes ot action that may arise <br /> , because of installation and maintenance of the improvement or <br /> � / other righl-of-way use hereto applied lor and tuAher agrees to <br /> ` lC-i-�� i.2 remove same upon notice trom Uie City and to replace public <br /> �INAL INSPECTION ��� property damaged t r <br /> pnwovea,s co�suuciea oaie - <br /> ' _/=:��-Q`� <br /> SignaWre ol App N Ua�e <br /> WORK AUTHORI7.ED BY THIS PEFMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS I;SUED AND TNEREAFTER IS TO BE DILIGENTLY PURSUED <br /> TO COtdPLGiION.THIS�[RMIT MAY BE CANCELLED�Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />