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PUBLl� WORKS <br />P�RMIT <br />PUBLIC WORKS DEPARTMENT <br />32D0 Cedar S1reol <br />Everett, WA 98201 <br />(425) 257-8810 <br />ANDADDRESS: J h 1�1 P.T�F.TIJLP.S ANDA�ORE55: pp}� <br />15730-A rnll;,;'�:1 CLi.�E DF: <br />2�7ILL r?'tEFR: WA `:1•i1i12 <br />PHON[: t���5�54�1yi? �t��G��OD� PHONE: <br />7'AXPARCELI.D.# 1 I) �p4 � il °ifil PRQIECTA�DRESS: i 4 <br />1 9_' 8�1.1_ _4�. <br />OESCRIPTIONOF _��� �_.,�„y, _�_, �(, ^' fT7"��TfT�,�' 1 17 "�T <br />PflOPOSEDWOPK: FNA iL-. 1iISJ _ i t� a 7_ JJ.fl J'Ti <br />1717 _•F�Tf? J1' >.L"_ <br />PERMIT CONDITIONS <br />Date "i o'cnph <br />PublicWorksPerm PW0612-026 <br />Building Parmit # �� . <br />Planning Re!erence # <br />Public Works Fee S �? �, n R <br />Guarantee 5 <br />?.C�TS 19� l�i, L: ��T}:C?: ;::.= "YLAT <'` <br />EJb'RETT DIV F. <br />1. All calls for inspection sha�l be made 24 hours in advance. <br />2. All work shall be performed in accordance with this permit and currenl City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Lor.ation Underground Service 48 hrs. betore you dig. TOLL �S �i E NUMBER 1-800-424-5555 <br />�. :'lY�i S/pLtL tr. ]�5 qnRc� jp4r 3����CrV9�j :lt.� jjl:a�� rj:ytF_rj �-h.;-li'j t�:opy at_ar_hea;. <br />�+. YL'{�Vld� an� L� �::1_�❑ ."•i1CYOl 8P. C�1L•-=rrt.orf �V C.}3� UUk��.1C �'.W01��i('. 1R3Y��_'CtOC. <br />ii. hrg�.• i.1C';' `:I_C...:r..�, �`l�dl) .:Y 3�.� 'ilO�S. :...�...:..�...�._.� . <br />'•. An.� :'-tn���ari „ <t-v11k .��.�n_i ;t��e:et ,`r'�ntac�u;: Nu,�.t t�e c�F���i¢�-1'd�� � - <br />��_ I` , , - <br />� n���Li�_ 01 D % O � <br />proved lor Construclion Dal <br />�rU �.F_-�%v� c <br />.� �._ e, ._ 1 /_/.�—� , <br />oaic <br />/ l�'�� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />'fhe undersigned ownerlapplicant hereby agrees to hold and <br />save hartnless the City ol Everelt Irom any and all claims for <br />damages, costs, expenses, or causes of action that may arise <br />becaw^e of instaGation and maintenance ol the improvement or <br />other righ4ol-way use herato applied lor and lurther agrees to <br />remove same upon noli:e from the Cily and to replace public <br />property mage r y. A <br />� (..v�L ���� % <br />Signature � Applicanl Uato <br />WORK AUTHORIZED 6Y THIS PERMIT MUST BE STARTE� WITIiIN 1B0 DFYS OF DATE PEFMIT IS ISSUED AND THEREAFTER IS TO BE DILI�ENTLV PURSUED <br />TO COMPLETIOIJ. THIS PERMIT MAY �[ CANCELLED OY 7HE CIN UPON ANY S70PPAGE OF WORK ON 7HIS PROJECT OVER 9D UAYS DURATION. <br />'pWp (��) pATABAR. INC. <br />Z <br />O <br />� <br />N <br />O <br />a <br />