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, <br /> PUBLIC W�RKS Date _ . <br /> i <br /> Public Works Pe:^��I# -�•- :�� . � <br /> PERMIT BuildingPermit# : <br /> �� PUBLIC WORKS DEPARTMENT Planning Reference# <br /> 3200 Cedar Street <br /> Everett,WA 98201 Public Works Fee$ <br /> (425)257-8870 ._ . <br /> Guarantee$ <br /> OWNER NAME APPLICANT NAME <br /> ANDADDRESS: -� ANOAD�RESS: <br /> PHONE: PHONE: <br /> TA%PAfiCEL I.O.!/ PRQIECTADDRESS: <br /> DESCRIPTION OF <br /> PROPOSED WORK: � � � - � � <br /> � <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made'<4 hours in advance. <br /> 2. All work shall be performed in a ce with this permit and current City of Everett Design and Consiruction <br /> Standards and Specificalions. <br /> 3. Call Location Underground Serw�.,: : irs. before you dig.TOLL FREE NUMBER 1-800-A24-5555 W <br /> � <br /> '�^ <br /> V+ <br /> � �. � . ; �: �: � � i � _ W <br /> I '7 '4 �... � T� - :..�fl npr ���.j IR.�] .Ur. � r� r.�lf� i� F:1�-rFtt Sta �18L �'; f� i 981P11 : . . <br /> . R_�.i�\ _ _r . __�I: C,.1.�_�1 . , a�.=_�� uF_n �_�_r���_�1_�!7 .._ �h_ X1�p�c :' C1 �C� t . ,.,, O <br /> - e <br /> ` � irJdl OT .t? li?'-'1J'_r. ' � <br /> f��. n� l pY��-f if :il II� i1'Bt.7."1�. �If<;Yi fnqM1AY2011� . ](��'�d�11: :Yflj •:�I.1VBv3Vg •;�1.YJ.1 [r• j�:,�� . . � <br /> B(1 a n f�.j =I.'f'`h�?�'. .� rJ. ,t 1 1 � .�.,� «t� �.� 111 '... . � <br /> r� � . ��l 'J wartin�� �� r�at?ri� o ] .i.�� „ �. <br /> . . .r_ :1L`.. :^.:li� !:�:'1:� 'L �_} LaS T4 t:.� tT3 i� '� J,^,.. . . , O <br /> _ . . I;_ I.uil��iu�a r.,�-r_e:al� to i>� srs:F-�, ,�n � t s.�- _ <br /> ;ri ,r :tt f r rb.:;i �_ian t!�� �� . �/► <br /> l,�iis�;' vat T t^� er b�,,; 1 ab,:•rr. ;id�val4 •r,,;. / <br /> -- . Pa•,�e cic.vew3_f ir_aa tne Yront c•Lo�est_r . . . - . V� <br /> _ _ . _ . _ . .. _ , . . . . , _ O <br /> T� PO���n� 6/2 ° �� a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> 1 , . /' / The undersigned ownedapplicant hereby agrees to holtl antl <br /> . � �, �y, , '� � /� save harmless the City of Everett trom any and all claims for <br />� � � � " -��'�' �� ' ` ���� damages,costs,expenses,or causes of action thal may arise <br /> Nppraved(o f.onstmclion D, because of inslallation and maintenance of the improvement or <br /> /l�.� '� <br />� �L�/ �/ /i.�_�. �/ other righ4of-way use hereto applietl for and further agrees to <br /> � G` �'- �% �'�c1 remova same upon nolice fmm the City and to replace p��blic <br /> fINaL wSPE ON property da ged thereby. <br /> Appmved as ons�mcled Date <br /> - �4,r_.. _ �'�O-O(� .. .. <br /> _ �gnaWre ol Appli t Date <br /> WORK AUil10RIZED BV THIS PEFiM1T MUST BE STARTED YJITHIN 780 DAYS OF DATE PERMIT IS iSSUE�AND THEREAFTER IS TO BE DILIGENTLY FURSUED <br /> TO COMPLETION.THIS PFRA11t MAY BE CANCELLED BY THE CI7V UPON ANY STOPPAGE OF WORM.ON THIS PROJECT OVER 90 D.AVS�URATION. <br /> EPWP I]lOGI DRTRBAR.INC. <br />