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��✓�: <br />PUB�ic woRKs <br />PERMIT <br />n��vnwncaa: - - . <br />PHONE: <br />TAX PARCEL I.D.N <br />DESCRIPTION OF <br />PROPOSED WORKi� � - <br />PERMIT CONDITIONS <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />cverett, WA98201 <br />(425) 257-8870 <br />�0 POSTING.....,.�PR.�.�, <br />APPLICANT NAME <br />� � ANDADDRESS: <br />PHONE: <br />PROJECTADDRESS: <br />I Date <br />Public Works Permit k � � . - <br />Building Permit # � � - - - <br />Planning Reference J! <br />Public Works Fre $ . <br />$ <br />V -(� <br />V /I ,, <br />FF� V <br />C, �l,r, f, <br />1. All calls for inspection shall be made 24 hours in advance. <br />2. All work shall be pedormed in accordance with Ihis permit and current City oi Everett Design and Consiruction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. betore you dig. TdLL FREE NUMBER 1-800-424-5555 <br />- --- r- -_ ;.... <br />r��.,ic F r,wn;F �uts to rh� cii insau - _ _ __ . <br />� . ;.r,��ion �."�:ttrc�l mea���G.•s u�r f•iry ,,i r � . .. .... t L, fl-�.. .,.-. .. j: - �� .. <br />.:.��nM! .I�J:lnp i'ORiCnl IDFK:Sli1' :1��PI't {'bIDr�l%✓ijpit :�f ir:B F�YO�c�t'i j��'I.'�_'�L tC� :ll;��. <br />.'�3_ �"� ij;•= :;.eC0.ilt, <br />.. E•:(�=.9': ;C:'-]�!4ir5C1.91 iL'^W i�'`�1I1��3t1011� 31��:='+.'31i: ,z0�3 ��C1VEif3'y': 9313''_ 1:•N li3U�e'7 : <br />.ri[rry_.,:i� �:�at'in'i.Y1.ar1 z:l`F. }7�.7 Wh3i7Cq Uf tOnY�'T'13] 13 f�.11��b_ii U!7 l'h5� C�II11(Ili:r1 . . <br />.: !.{l.F"r C:iJi�. Cpi_�:7 O[ :�a�?i,'1: 'i', �T.: tC�3O�CF�j iifl!'n Cn:3�i•.:3,�. <br />.iO L�U:ll��lfl� L:3L2!13��3 LC� t��c �?'BCi.^_'Ci 77! �'i!��W311::; 377•:I .,1C121:3�1;� :G r.c• };Ept <br />-i•�tl __�C ;:��tE::TCi311 C�.g.`i�l.. <br />�. i��ust .;at;,r m:-t.r.� b.::�x i•� _iY„-�re• s�;io�,�alk >:r -i�.Ir�. <br />�'11qV«;? .ii1p C�";:'1.3�3'r_ q�lCfi� t��}^r�>� .:Il� :�St.i�q'J.3.1�{ .gf j?c'C ('1"}' t�L .FVpCFtt $^.9i1f.t; . . <br />. . s 'iih OP. Lt:1.� �L_���_'_til' ZL:'i`.9'.!,' 3.^'. __�__ ..r� t . :. _....��_� t'� _. _ _.. _... <br />u�,us�i drivew37s and an� f>c�rk?n �.._ iamiq.:,; _ <br />- - - .- - - - �, <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownor/applicant hereby agrees to hold and <br />save harmless Ihe City ol Everett from any and all claims for <br />damages, costs, expenses, or causes of action that may arise <br />because of installation and maintenance of ihe improvement or <br />other righFof•way use hereto applied lor and furlher agrees to <br />remove same upon notice trom the City and to replace public <br />propeAy dama e thereby. <br />t <br />� -a-�g-o7 <br />SignaNreotApplican! Dale <br />WORKAUTFIORIZED 8Y THIS PERh11T MUST BE STARTED WITHIN iB0 DAVS OF DATE PERMIT IS ISSUEDANOTHEREAFTER ISTO BE DILIGENTLY PURSUE7 <br />TO COMF'LETION. THIS PERMIT MAY OE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />EPWP O/O6) DAT4BFFl.INC. <br />/ <br />Z <br />O <br />� <br />� <br />a <br />