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PHONE <br />Pus�i�c woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 r,edar Street <br />[verett, WA 98201 <br />,425� z5�,�,�p�i�AIG _� -�g —�6 <br />EhC=.RI Hft•SES INr <br />rPiE A4C Fi�l iT F�I 9 NE <br />L.AF:E :iTEVETJ:i L'n )b'G58 <br />9:b259q80p <br />q <br />23G40i0020030 <br />DESCRIPTION OF _ y y <br />PROPOSED WORK: 17EW HC!'.I�E -E�ASIC _ <br />FERMIT CONDITIONS <br />PHONE: <br />PROJECTADDRESS: <br />Date <br />Pablic Works Permit # <br />Building Permit # <br />Planning Reference # <br />Public Works Fee 5 <br />Guaranree $ <br />�r iilc:'���� <br />Fri0ou2-0�0 <br />C0602-034 <br />525.uU <br />GLEtl'rJi:,-,p rp'�c,T, Lc:,: 5 <br />1. All calls tor inspection sh�ll be made 24 hours in advance - phone (425) 257-8810 ' <br />2. All work shall be perfornied in accordance with tnis permit and current City oi Everetl Design and Consirurtion <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you diq. TOLL FREE NUMBER 1-800-424-5555 <br />4. ronaa�:r .:i�9� :.,a:,ac pe� C;.y 3t.a;r:ar7 a�� i;i, �,'--� r';`•• <br />�. ('Of171%'�:C Li�_:[;.iY� •;jC��.q]B��OUL: t•� i}16 •�Lil(13_:1'-' :'-VcLE9G F�IO'v'lil�_'il "OC C}1!3 I��L. <br />O. III.�Y.Si,. =„!�>l�;tl =��IIYC�,1 i4E..5Ulcg .9� .}gCFYfGl.:la_�i �i}' '_.._ PU(?L1C Wpt},& 1RS�•E.�7r�?C, ..�ril <br />.. ,... �.- . , .'':3�,. 1 .f: , � �y-"`� : . .. i$]:�f C:_i........ , <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />- <br />� <br />W <br />O <br />Z <br />O <br />H <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless ihe Ciry ol Everett Irom any and all claims for <br />damages, costs, ezpenses, or causes of action ihat may arise <br />because of inslallation and maiMenance ot the improvement or <br />othecrighF way use hereto applied br and lurlher agrees to <br />�move same pon notice irom ihe C' and to r place public <br />`pmperty dam � ged tiereby. <br />� � 3 I> 0� <br />� <br />SignaWre Applic Date <br />WORK AUTHORIZED BY THIS PERMI7 MUST BE STARTED WITHIN 1BC OAYS OF DATE PERAIIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PUfiSUED <br />TO COMPLF710N. TNIS PEPMIT AMY BE CANCELLED 0Y THE CITV UFON ANV STOPPAGE OF N'OqK ON TNIS PROJECT OVER 90 DAVS DURATION. <br />