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�:; PUBLIC WORKS PERMIT �ute: 7I17I2013 <br /> Public Works Permit#: PW1307-009 <br /> City uf Everett Public Works Department <br /> /`- �,� r �, ..f-,�, 3200 Cedar Street , �` Builcinq Permit#; <br /> Everett, WA 98201 , Planninq Reference #: <br /> (425) 257-8810 <br /> Public Works Fee $: S 20.00 <br /> Other 5: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: � <br /> CIlY OF EVERETT IMAC INC <br /> 802 E MUKILTEO BLVD SPENCER DONALDSON <br /> Everett WA 98203-21 MOUNT Wq 98273-9 <br /> PHONE: 4252448182 �� PHONE��.N 3604247013 016 <br /> TAX PARCEL ID iF SITE ADDRE55: 1201 23RD ST <br /> DESCRIPTIOrI OF PROPOSED WORK: <br /> STORIJ�WATER SYSTEM-BP,YSIDE PARK <br /> � <br /> PERMIT CONDITIONS <br /> 1 All calls for inspection shall be made 24 hours in advance. <br /> 2 All work shall be perfor;ned in accordance with the permit and current Ciry o(Everett Design and Construction Standards <br /> and Specifications. <br /> 3. Call Locatio� Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br /> 4 Plans approv.-,d for stormwater system only. T, ^ <br /> rTl �..il�i <br /> Yuur Public V�orks Inspector is Randy Allen. Call him at 425-339-7403 for questions and inspections. =�� �^W <br /> _, . F <br /> �Jr : <br /> � �i, �i Vl <br /> ;� _Ir'w <br /> � T `Q <br /> i <br /> i C_O <br /> ~- ,i <br /> rn <br /> � �� <br /> r.t _O <br /> O C. <br /> ..;, �,. �F <br /> �_:Gc -, i � <br /> `—�r_ <br /> � _ � J <br /> ACKNOWLEDGFMENT Of C(`NDI I IONS <br /> The undersigned owned.�pplicant herch� ,�j�ees lo hold and <br /> save ha�mless Ihe Cily o(Everett from:,�ry ard all clalms for <br /> damages, cosis, expenses,or causes o1 2cliun that may anse <br /> because o(mstallalion and mainlenance of the improvement <br /> r ,-��/�� or other iight-o(-way use hereto appliea tor and further agrees ; <br /> App ved Or Onstr Dale to remove same upon nolice from the City and to replace i <br /> public property damaged ihereb . i <br /> �-3 - 1.�� � <br /> NAL INSP TI N Oate ��- � � ��"�� � <br /> Approved as Constructed SignaWre of Applicanl Date <br /> WORK AUT710kiZE�J BY i}115 PERMIT MUSf BE START[D WITHIN 180 DAYS OF DATE FERMfT IS]SSUED AND THEREAFTER IS TO BE�ILIGENTLY I <br /> PUP.SUED f0 C07�19LEIlON. THIS PERM(i h1AY BE CANCELLED BY THE Cf1Y UPON ANY STOPPAGE OP WORK ON THIS PRO]EQ OV[R 90 DAYS UURATION. � <br /> ^ ` i <br /> T w <br />