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PUBLIC WORKS Date = =- - ' / <br /> Public Works Permit N . "'''",i1� �:._ <br /> PERMITBuildingPermitp `--J .e <br /> II PUBLIC WORKS DEPARTMENT � S r V <br /> f 3200 Cedar Streel Planning Reference N _�'�„� J �.p1 <br /> Everett,WA 98201 Public Works Fee S - � <br /> (425)257-8810 � - <br /> � �.i i���S71P�IG..s`.P..�..O,.1C0 GuarantaeS <br /> OWNER NAME APPLICAN7 NAME <br /> ANDADDRESS: - � .� ' �'�'�" ANDADORESS ����"',' .� '� --•- <br /> PHONE: PHONE: � - . <br /> TAX PARCEL I.D.p . . . . . . PROJECTADDRESS:. „ <br /> DESCFIPTIONOF . . . _. . ._ . . ._. .... . . _.._ __..___. <br /> PROPOSED WORK: � ' � ' � � � � � ��' ' "- � � � � ' - - - � <br /> PERMIT CONDITIONS <br /> 1. All calls tor inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and ConsWction <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-024-5555 W ; <br /> � _ _ . . � <br /> _ ''-_ - , . . - _ ��/� <br /> - . V� <br /> W <br /> �:r, O <br /> � <br /> -- .,��1"r��E; 2 'I k�^C I Z <br /> � ., -._ - - 0 <br /> �"' <br /> �'- f✓C%f= �' siTr� �.v�:.<',C' �'�'��i/�EI� f-i'lry (II <br /> �,�/.s ���.�iT /�/S .5��`✓��i n�✓ O <br /> vs'� -�i 5�-'�. e� �S� ����'�•/ ����i7 �/c7�".S� a <br /> / ��� /��/�'�� ;;i c-ci�S ���J� Gii=��/�,E <br /> — ACKNOWLEDGEMENT OF CONDITIONS <br /> � % � , The undersigned ownedapplicant hereby agrees to hold and <br /> ���// ^ ^ � <br /> � �` /L, J . � � save harmless the City ot Evorelt irom any and all claims br <br /> fi_-}� damayes,costs,expenses,or causes of action that may ar � <br /> Appmvc�tl for Consimction Dafe because of inslallation and maintenance ol ihe improvement or <br /> � i/� other nght-of-way u�e hereto applietl lor and fuAher agrees to <br /> ��� _ ��.� � _ remove same ofi notice ilnm Ih 'ty and to replace public <br /> (L INSPEC710N � prope� agE/dJ'��e� � <br /> Approved as Constr�cted Oato a� .�. <br /> Lsf '1' • � �O�ZD� O� <br /> - y-,� _ �� - - - - - <br /> ignaWre ol Applicant Date <br /> WORK AUTHORIZED dV THIS P[RMIT MUST BE STARTED WITHIN 180 DAYS Of DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUE� <br /> TO COh1PLF710N.THIS PEFMI7 MAV BE CANCELLED BV THE CITV UPOIJ ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br /> EPWP piOG� O0.TABAR.INC, <br />