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Pus�ic woRKs <br />�ERMIT <br />PUBLIC WORKS DEPARTP �ENT <br />3200 Cetlar Sireet <br />Everett, WA 98201 T O ��, I I IV (` <br />(425� 257-8810 � V <br />�WNERNAA�,`�^� T ^ APPLICANTNI <br />4NDADUHE35'� AAt: ����1 .'iT kT � I:� ANDADDFES: <br />LhY,E iTEVEh:S 47'r. 9$��•E <br />9�5iS�90801J <br />PHONE: <br />='^�^vi+�':+:::::'� 6�i': <br />1:\% PARCEL I.U.71� � <br />NEW HU'.i:E - PA:;IC l�ii <br />DESCRIPTION OF <br />PFOPOSED WORK: <br />PERMIT CONDITIONS <br />PHUNE: <br />31 <br />11;'�Ej�005 <br />Date <br />PLtq �ll-n.,0 <br />Public Works Per.iit #� py ll- 0� 1 <br />Building Permit N <br />Planning Reference 7f <br />�}�t Works Fee 5 <br />Guarantee 5 <br />1. All calls for inspection shall be macle 24 hours ir advance - phone (425) 257-8810 <br />2. All work �hall be performed in accordance with Inis permi� and current City of Everett Design and Consiruction <br />Standards and Specifications. <br />3. Call Localion Underground Service 46 hrs. be(ore you dig. TOLL FHEE NUMBER 1-800-424-5555 <br />'i. �.�.�1.!�ilifl.i. :i1�Y i'%'w�PC jJ�3i I.i.:� ji:.}�:".iCU {��.� Ulii� (�Ii�G• .:9. <br />-. _cnine_:c cooitop .:It�r.+naputtLa �.� tn<- :ieain:�y=� 2vstem r,ct,•o�_tiaci :oi. [ni: lot. <br />.. 7119ta11 ECG51��❑ �]�:IlCCO'y IIIF.A:)UCr_8 d9 �irta_CIG11lE�i �?j� YilE- t�U�"�a.i�' ib"_�:S 1179�>Ei_���L� SUCII <br />d`; Silt. fenCe� 5ti3w b_"il:��� 3l.'31^:'3� 6C ALi�816R �iTFltil:�t.�. fRi•_l:, ���i-=%!?-'(•i!iil <br />. 1.119�31! P_C:��II:II :,�;ALL^1 IR9.3:1�lLr�F d.`i ���3C5CItilllr?ij j�'; /,�1� LV.�)liQ FipCi:S 1i78[�r?t.:CDI� i�1C�` <br /><i�d .'.ljC ic'fIC�'� _.TLnr. C�1�i='.� �.+.-ii",. ... �Li,'.L-`Il i_.-,i:�:-•IL. <br />tor <br />Appmvetl as <br />/ SoS <br />) �uie � <br />� -- 7 E <br />Date <br />� �:,,:.- , i.. <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />W <br />O <br />Z <br />O <br />H <br />O <br />a <br />The undersigned owner/applicant hereby a9rees to hold and <br />save harmless the City of Everetl from any and all claims for <br />damages. costs, expenses, ar causes ol �ction that may arise <br />because ot installation and maintenance of the improvement or <br />other right-of-way use here�o applied for and turther agrees to <br />remove same upon notice trom ihe City and to replace public <br />property damaged Ihereby. <br />Signature of Appticanl <br />Date <br />INGRK AUTHORIZED BV THIS PERMIT RAUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED ANU THEREAFTER IS TO BE DILIGENTLV PURSUED <br />TO COIv1PLETION. THIS PERMIT MiAV 6E CANCELLED BV THE CIl'V UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVcR 90 DAYS DURA710N. <br />