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�.�,�,�r._ <br /> PUBLIC WORKS II Date _:l20Qi <br /> PublicWorksPermitk .. �--�.��03-03� <br /> P����� I BulldingPermitp �7) 033 <br /> PUBLIC WORKS DEPARTMENT plz�ining Relerence N <br /> 3200 Cedar Street <br /> Everett,WA 98207 P�blic Works Fee 5 - <br /> (425)257-A810 ' , _- ,°�,'�' <br /> Guarantee S <br /> OWNERNAIdE � APPLICANTNAME � <br /> ANDA�DRESS: ,:;,}�_'y? .;i'_ii.��,..., L,j'.)'� . AN�ADDRESS: �-j�,nY Y•:.,..-. <br /> -173�) COLEy A�,lE PnI'[EBP.LL _ -_.'. ��s . —. <br /> c;,,SPW i P GA .-;-J�"� i <br /> � PHONE: ' PHONE: ' <br /> 7_�_�'_Pei,�r _ —_.{I <br /> I`TAX PARCLL I.D./f PROJECTADDRE55: I <br /> 'ilh=,''.�f:'ifli:lfi�� _ _ 7iii[ �:rT;: ' _ _ <br /> I�U[SCRIP'ION OF � <br /> � PROPOSEOVJORK: ,�. ' �'...._ . . . , . . ..� . . , .� . � <br /> I <br /> �I __ .__ _ ___—__—__.._.. . _ _'__—'_ J <br /> _. ____ . . .. _ . . . <br /> PERMIT CONDITIONS <br /> 1. All calis tor inspectio�i shall be made 24 hours in advance. <br /> 2. All work shall be per(ormad in acwrdance with this permit and c:nrent Cdy o� Eve�ett�esign and Consiruction <br /> Standards and Specifications. � <br /> 3. Call Locatian Underground Service 48 hrs. before you dig.TOLL FR�E NUMBER 1-800-424-5555 <br /> � <br /> '�^ <br /> V+ <br /> W <br /> TQ P�ST��:' i � 17�C} � <br /> 7 <br /> Z <br /> O <br /> H <br /> „ �� - cn <br /> �> �� �u� i�-; O <br /> JUL 2 0 200� � a <br /> Cf[ Y CF l:Vf�I�1il"I- <br /> P�rmit �cn i��cs <br /> r - — -" - ' ACKNOWLEUGEMENT OF COND!TIONS <br /> � The undersigned owneriapplicaN hereby agrzes to hcltl and <br /> I ' ��' save harmless the Cit of Evr,re��Irom an and ail claims br <br /> li _ —_- . �_ ;,,?; �. �.��1� !. .��::%R;r+,� _ Y Y <br /> � ��' tlamages.costs,expenses,or causes o!action that may aricc <br /> I .Appio4etl for Constmciien" �� � Daie� because of mstallation and main(enance o�the impmvemen�or <br /> other right-ol-way use hereto applied lor and further agrees to <br /> li �"�_ ������`��/ remove same upon no�ice imm'��City and Io replace public � <br /> INSPECTION propert/tlamaged thereby. <br /> li Appmved as Cons�mcted Date � - <br /> I�. '_____ _�_z� �"_'�J ~SignaWreolApplican� .' ..Dale ` ' <br /> IVORK AUTHOHIZED�V THIS PERh11T IdUST OE STARTED WITHIN 180 DAYS OF DATE PER611T IS ISSUED AN�THEREAFTER IS TO BE DILIf,ENTLY PURSUED I <br /> TO COMIPLETION.THIS PERfAIT�1AV BE CANCELLED BV THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DUFATION. <br /> (PWP l]:051 OATABRR.INC. <br />