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s <br /> r <br /> w�e : _i.��r,n� � <br /> PUBLIC WOi�KS PublicVJorksPermi�# t`drgf��-n'� <br /> PERMIT `;�"'-_n>' <br /> I Building Perrr.i�F' - <br /> PUBLIC W�JRKS DEPARTMEN f Planning Relerence�Y <br /> 3200 Cedar Street <br /> Emret�.WA98201 c.,; ;,0 <br /> (425)257-&870 Public Works Fee S • •� • � � <br /> Guaranlee 5 <br /> OWNERNAME ' APPLICANTNAME <br /> ANDAODRESS: , ,�;-,�Tj�r :,rr.x,^,j.: ANDADDRE55: <br /> pi� p.OY. 'L:-�' <br /> i^,F'.IFLx ,:.� '•P:� .�7 <br /> PHONE: PIiONE: <br /> TAX PARCEL I.D.# PRQIECTADDRESS: ,,.. <br /> ?0.(15� �yi_rli,,�il(Ic]f1i1 " _ '.''T.i .�i1`_ 1L <br /> DESCRIPTION OP _ _ ,._ <br /> PROPOSEDWOflK' .�� .:? ....''ii� ���-.'fL'>°� � ' '_.N:i.i:. <br /> _ - _ —_ !, � <br /> PERMITCONDITIONS ' ` " - <br /> i. All calls lor inspection shall be made 24 hours in advance. <br /> �. All work shall be nerlormed in accordance with ihis permit and currenl City of Everelt Design and Construction <br /> Standards and Specificalions. <br /> 3. Call Location Underground Service 48 hrs.before you dic�.TOLL FREE NUMBER 1-800-424-5555 W <br /> - . . � . .__ - bc .,..:t ' = P _.__'- :'i = . �L';_ ,a:- � <br /> _ .. . _ . ,.,,, ., .. : ,.. ,.; ,. : , - <br /> , . _ .� _ _ _ ... : _ � <br /> _,. ._ ' _ : .. _ . ..� '_Vla 3°='_�._:1�:•� ,:L._':L:1: � <br /> .�_ /7�''� O <br /> ' /��S o�c�l �� �..L� iSs�,t.v � w/p�,,,.c� ��o�' 61.�0�� ' <br /> / <br /> y(.�;,�.< l/,{ c /�a c � J f-�i�L ui_ .c/�.� Js.� �� ��it,�s Z <br /> s�.-, ti��E.� � <br /> H <br /> N <br /> � <br /> a <br /> � ---— ---- ACKNOWLEDGEMcNT OF CONDIT�ONS <br /> � / ,(� iha�ndersigned ownedapplicanl hereby agrees to hold and <br /> �f' � /a�L����, sava harmless the City ol Everett hom any and all claims lor <br /> {�. C� damages,costs,ezpenses,or causes ol action that may ari;e <br /> appmvetd br Construc�ion Da�e becausa of installation and maintenance of the improvem:nt or <br /> other right-of-way use hereto applied lor and further agrees to <br /> remove same upon no!ice irom Ihe City and tc replace public <br /> FINAL INSPE;710N pioperty tlamaged Ihereby. <br /> Approvetl as Consimcled Dalc <br /> __ _ � SignalurcolAoplicant Dalo <br /> VJORH AUTHORIZED�Y THIS P�RMIT MUST BE STqq7ED WITHIN I80 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED <br /> TO CCMPLETION.THIS PERMII PAAY BE CA�dCELLEO BY 7HE CITY UPON ANY STOPPAGE OF WORK ON THIS PrIOJECT OVER 90 DAYS DURATION. � <br /> EPWP PI06� <br /> DATABAR,INC. � <br /> � <br />