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PUBLIC WORKS <br />� <br />�� <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everet�. WA 98201 <br />(425) 257�88:0 <br />: r,a_ du l �ii�a�1S <br />OWNERNAMiun �40 ri::l ST R1 �' }i'L' <br />AND ADDRE35'i' <br />LP.FIE STEVENi kT•. 98�Sc <br />9�Siy5DSD0 <br />PHONE: <br />J 4::a(1� (�[�"'llflp f�;. <br />iAX PARCEL I.D. #�;� HG[ISF Tr a: � <br />' PhS. i.., . <br />DES:RIPTION O� <br />PROPOSED WURK�. <br />PERMIT CC�NDITIONS <br />JUL 3 0 <br />CANT NAME <br />PHONE. <br />PROJECT <br />11i29i?005 / <br />Dale <br />YWU511-041 <br />Public Works Permit i�US il-0:::: <br />Building Permit # <br />Planning Re(erence # <br />Jcl.uU <br />Publi-: Works Fee $ <br />Guarantee S <br />1. All calls for inspecticn shall be made 24 hours in advance - phone ('.?5) 257-9810 <br />L. All work shnll be performed in acwrdance with ihis permit an� current City of Everett Design and Construction <br />Slandaros and Specificalions. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />�. C<�nnerr side sasn=c pec i: itti- Staad 3cd a' : 601, r.;iiL, riU�. <br />5. Connect L'JOfYOp i�OWRSF�OLICB Cn 2}lB 43C33113J2 ::Y3T�ttl C�CCrpy(�-•:� ZOC L.113 IGt. <br />ri. L�staii ZCp97.0❑ Ci:li%C!:I G1EdSUC�?:' ;38 �jE'r�C10-ill�li 1?Y r�lE T'11J�.1C W�!C}::. 111fi�:E,-':�-Y� <br />�� �lli fFne«, stea4� t�31e3� 3{Jn�f� :�L _.:031071 .�1311yE'2.3. (%:1{:i:� 4Z�,-J:9-790: j <br />7. I11ET311 �L1�91!)G L'OIltCOl NEd:IJb_:. d: �jP_`EI:V1IlE�.j IlY t:1N PUI?L1C GiDY}::: 1R:'D�CiJC� <br />as sllt fenc•�=, :tiaw bale�, ati•.,l=_�s _'' -_::lun t,1;nF:eta. <br />� u�: li <br />;i�:�: <br />ACKNOWLEDGEMENT UF CONDITIONS <br />Z <br />O <br />H <br />O <br />a <br />Tha undersir,ned owner/applicant hereby agrees to hold and <br />save hermless the Ciry ol Everett irom any and all claims tor <br />damages, cosis, ezpenses, ar causes of aclion that may arise <br />because of installation and maimenance of ihe improvement or <br />other right-of-way use hereto applied lor and furtlier agrees to <br />r=.move same upon notice Irom Ihe City and to replace public <br />propertx damaged Ihereby. <br />'�Y�f�Gl�L. �Z�/I'QS <br />Signalure of Ap licant q/ Da�e <br />f ., <br />� � �° �� � <br />WORK AUTHORIZ[D BV THIS PERAIIT MUST dE STARTED WITHIP! 180 DAYS OF DATE PEPMI7 IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED <br />TO COMPLETION. THIS PERMIT MAV BE CANCELLED BY THE CI1V UPON ANV STOPPAGE UF WORK UN THIS PROJECT OVEfl �0 DAVS DUFiATION. <br />