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.� <br /> � � <br /> PUBLIC WORKS Da�e o/3%2005 � <br /> •� PublicWorksPcrmitq FWU50U-005 <br /> r <br /> 'r ����iFh'I) �7 '�i r05oo-007 <br /> P������ ' � Ql�lf}? guildingPermitu <br /> CT 7 <br /> PUBLIC WORKS p��}fiiT1nENf c�an Planning Relerence k <br /> 9200 CedarSifd�t'��'�}'��`��'��" <br /> Everen,WA 98201 Pub�ic Works Fee S � <br /> 425)25��Baio 1' U5. ;1,;';;.'`� 5..5 .00 <br /> ( 11 <br /> � � j� t��1 ��1 GuaraNecS <br /> «:^u Coq (h1 <br /> OWNERNAME •n U S . - I�?N APPLICANTNAMF 9 <br /> ANDADDRESS' E+�i p,� ' '� ANDADDRES$:�"�•���. ^ /�/�� <br /> � ,r. ia��s , . T. ����, OCT 2 4 20D5 <br /> i D,: n� r.�,,.�:�, , �•�,� <br /> M.�F;YSVILLE p,� ��?70 _.: ----_� <br /> � bJii:l,�'f I <br /> 3606571427 I Eirl�ri;' �')i1,!;n] <br /> PHONE' [�1� PHGNE � <br /> 1 `Ii� �t� �i.��'����,i,il <br /> TA%PARC[LI.D.# �bU tUO3U:i1U0 ;. l:HitK PROJECiAO0F3L'SSUO ug�ip �3Fp ,���f; SE 11L�4' S <br /> r -r . ' _ „) ' I_. <br /> DESCi'IPTION OF <br /> PROPOSEDWORK C:�}'.I�: � � �- -�'�,.;'1,'•.(';��, <br /> PEFMIT CONDITIONS <br /> Sii�iF.T FLAT 1�O:t-01'7-ii::, T.C;T 5 <br /> 1. All calls (or inspection shall be made 24 hours in advance- phone (425) 257-8F110 <br /> 2. All work shall be per(ormed in accordance with this permit and current City of ['.verett Design and Construction <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800-424-5555 <br /> 4. r•„nnecr_ si.de �ever pec City Standacd i!'s 6U1, 502, 609. W <br /> Ci. kooftop cunozi must b� tli;:chacged to a coof dovnspuut infiltcati_�n system pe� pl,t � <br /> rFquic::menr, (see attaclied} 'A <br /> 5. The contractot must meet with th= Public Worl:s Insn_ctoi to discues patential ��� <br /> deainage rnutina ptioc t:n beginning the peajert. M <br /> 7. install eco�ic�n contLol measuce� X�ei City of Ev�cutt Stan�lacds for small • ar�•,als W <br /> 8. kem��ve aLOul��❑ ?VI1CCrij N@d:7i1C�'d U�)n❑ i79111�tj�.t1�?❑ �if t�lr_ �:��_�)F�7L' �iCln� t�_ fllldl O <br /> approval of th� puemi� . � <br /> � 7^ct^ll 5 'li __:.-�.3:�3F. -.r � ��� <br /> Z <br /> O <br /> H <br /> � <br /> � <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � / The undersigned ownedapplicant hereby agrees to hold and <br /> � .. Cr9 �� save haimless Ihe City ot Everett lrom any and ail claims lor <br /> A provetl lor Conclmclion oaie damages,cosls,expenses,or causes ol action ihat may arise <br /> 6ecause ol installation and maintenance ef the improvement or <br /> / •� l� / z — G,5 other righhof-way use hereto applied for and further agrees to <br /> �" - � �"�-. - - - �� _ remove same upon nolice from d.�Jity and to replace public <br /> AL INSPECTION property damaged thereb . ' <br /> Appwvetl as Constmctetl Dale `= 1 �( <br /> �4 � c' ��Q ��G1.1_,��ILZ'�� �' �����5 <br /> Sigwture ol Applicant Date <br /> WOFiK AUTHORIZEC dV THIS PERMIT IdUST BE STARTED WRFiIN 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE CILIGEfVTLV PURSUED <br /> 70 COIdPLLTION,THIS PERId1T PdAY BE CANCELLED�Y 7HE GTV UPON AMY Sl"OPPAGE OF WORK ON THIS PROJECT OVER 90 DA'!5 DUHATION. <br />