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� ' PUBLIC WORKS <br />PERMIT <br />PGBLIC WORKS DEPARTMENT <br />3200 Cedar Sireel <br />Everet�. VJA 98201 <br />(4251257-8870�,1f'y(�'�` p�/9 �Gl� 0 j <br />J:. . �ilil7 __—_� <br />uwrven rvNme „(u.:t'. -�.�.� 1H A'dE :iE � � <br />;1ND ADDRESSr AND AD <br />soT�Lr. �h ���oi:: <br />9�5'193:71g <br />PHONE: PHONE'. <br />TAX PARCELID.0 ,±" � ` ��� � PROJ[C <br />h�!i F.�;USE - T_'�:t5:�" '�i=� <br />DFSCRIPTION OF <br />PHOPOSLD WOfiK'. <br />PERMIT CONDITIONS <br />11, !�:+; �Oi�S <br />Date <br />:[d;l�,.j-�i': i <br />Put��.. JJorks Permit #,-�; � r. �'.- i�� .� �; <br />Building Permit # <br />Planning Reference r+ <br />:c�.0 ; <br />Pubfc Works Fee 5 <br />Guaranteu 5 <br />1. All calis lor inspection shall be made 24 hours in advance - phone (425) 257-8810 <br />2. All wo�k shall be performed in accordance wiUi this permit and current Cily of Everett Design and Conslruction <br />Standards and Specifications. <br />3. Call Location Underground Service �• hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555 <br />ti. :�onR�3Cr ,lde �r��.n2[ pee C�ry ;t.aRdaC�i:: nOl,u�i�.r;f;-I. <br />:. Conr.e_�r i�_,��Lti�p �L_r.rns���_,uts t;� th2 �9tiainacl� �yst•�m c.c�.�•;:cie:; .-, t:ir-� 1•__. <br />.. Z119C�i:= =Ci�91�qi �'��172C=�i J�2d:�iC�F. 3S �jEt'.:C191!1��: �iV �..r ��il?�'_': „_I.r.S`:i1.J�.•��-.vC 5U.'!: <br />. .. . - . . .. . _ . � _ .. . . _ . <br />� `-"1�.'c'r - � . . . _ ,,..,. ..,_ <br />'�.:: : :_ - _. , y. i, �.-,; .�.. �:. .,�I� ._::i ��nL..•.,.. <br />ACKNOWLEDGEMENT OF CONDITIONS <br />/� <br />Z <br />O <br />H <br />� <br />O <br />a <br />The undersigned ownerapplicant hereby agrees to hold and <br />save harmless the City of EvereL' irom any and all claims for <br />damages, costs, expenses. or causes ol action that may arise <br />because of installation and maintenance of the improvement or <br />other right-of-way use hereto applied br and further agrees to <br />remove same upon notice from tho City and to replace public <br />pr perty da ed Ihereby. <br />.� � � ���� _ <br />�t / <br />�Y�� <br />Signatur of Appli[an� Da�e <br />WOI?K AUTH[iR2ED �V THIS PERMIi MUST �E STARTED WITHIN t8n pA�S OF DA�[ PERA97 IS ISSUED AND THEREAFTER IS TO BE DILIGENTLV PURSUED <br />TO CC`APLETIOtJ 1Hi , PGR1dIT MAV 6E CAllCELLEO BY THE CITV UPON ANV S70PPAGE OF WORK ON THIS PROJECT OVER 90 �AYS DURATION. <br />