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PIJBLIC WORKS PERMlT Date: 1I20/2015 <br /> �� '' City of Everett Public Works Departinent PubliC Works Permit#: PW9501-044 <br /> -"r 3200 Cedar Street Building Permit#; <br /> �•: Everett, WA 98201 Planning Reference#: <br /> �425)257-8810 <br /> P�iblic Works Fee $: $ 25 00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> WDH-BR <br /> 1225 E SUNSET DR ST145#823 <br /> BELLINGHAM WA <br /> PHONE: PHONE: 3607383116 <br /> TAX PARCEL ID# SITE ADDRESS: 10010 23 AVE W <br /> DESCRIPTION OF PROPOSED WORK: <br /> SET A °OLE <br /> (1/20I2015 2:02 PM BES) <br /> SET A UTILIY POLE <br /> PERMIT CONDITIONS <br /> i. All caAs for inspeciion shall be made 24 hours in advance. <br /> 2 All work shall be performed in accordance with the permit and current City of Everett Design and Construction Standards <br /> and Specifications. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br /> 4. Any damage to sidewalk, driveway tec.. should be replaced per City of Everett Standards. T � .. <br /> m <br /> 5 Traffic control should be per approved drawings 11I10/2014. �� �y ° <br /> 6. There should be at least a minimum of 5'(five feet) seperation between City of Everett utilities and direct onal=. • [W�, <br /> L�rOa-. o C'' <br /> boring. z z o <br /> 7. Contractor must cont2ct City of Everett Inspector �' � T � � <br /> Ciiff Lindman 425339-7404 prior to starting construction. � G � <br /> F• 'J <br /> cn c jO <br /> (y '--• � <br /> � <br /> Q! J <br /> GJ �� <br /> .Ln .— �r. �O <br /> j'y� un c.n r..:� <br /> �.� rao�--• .� <br /> .n cn r�. <br /> ��. c,• <br /> c�o i�� o • <br /> C7 C.'1 _'�O <br /> �� <br /> � /S _ <br /> � " I+1 <br /> ACKNOVJLEDGE-MENT OF CONDITIONS <br /> The unde�signed ownedapplicant hereby agrees fo hold and <br /> save harmless lhe City of Everetl from any and all ciaims for <br /> � • damages, cosls, expenses, or causes of aclion ihat may arise <br /> because of installation and mainlenance of the improvemen� <br /> / � 'Zv�J— or other righl-of-way use hereto arplied for and further agrees <br /> fo d fof ConstrUCfio 0 e to remove same upon notice from ihe City and to replace <br /> P public property damaged lhereby. <br /> FINAL INSPECTION Date � �/1�/�S <br /> Approved as Constructed Si ure of pplicant Date <br /> WORK AUThiORIZED BY THIS PERMif MUST BE STARTED WITHIN 180 DAYS OF DATE PERhiIT IS ISSUED AND THEREAfTER 15 TO BE DILIGENTLY <br /> PURSUeD TO COMPLE170�d. THIS PERMIT h1AY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PR:IJECT OVER 90 DAYS DURATION. <br /> F�(e <br />