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K <br />�a <br />�� � <br />:.� � t�r=` �,'_,r� t;> <br />�>:.. . <br />PUBLIC WORKS PERMIT Date: 11/5I2010 <br />Public Works Permit #: PVJ1011-003 <br />Ciry of Everett Pubiic Works n ie�lrtmUgF1�LED/ 15:11 guildinp Permit #; <br />320 darStreet�E�-1 G2'i�71 <br />Eve t�A 98201' CT Planning Reference #: <br />�Q�t�n�I� tlo8lU�iG03 <br />Public Works Fee S: $ 25.00 <br />�� � ��� �i Other $: <br />TL �A�A61`f3,�JT NAME AND ADDRESS: <br />OWNER NAME AND ADDRESS: t�,htCK � <br />SUSAN L KELLEY ~ SAM�'A�� OWNER <br />10314 19th PLACE W. <br />EVERETT WA 98204 <br />PHONE: 4253536040 PHONE: <br />TAX PARCEL ID # SITE ADDRESS: 70314 191h PLACE W <br />DESCRIPTION OF PROPOSED WORK: <br />DRIVEWAY <br />PERMIT CONDITIONS <br />1 All calls for inspection shall be made 24 hours in advance. <br />2. All �Nork shall be performed in accordance with the permit and current Ciry o( Everett Design and Construclion Standards <br />and Speci(ications. <br />3 C�ell Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 � <br />4 CUNSTRUCT DRIVEWAY PER CITY STANDARDS. <br />�} ,� �����oo�s <br />Se ���. <br />�Q' 2-����� <br />Lia <br />� <br />.., <br />� <br />G� <br />� <br />� <br />z <br />0 <br />� <br />a <br />ACKNOWLEDGEMENT OF CONDIiIONS <br />Thc undersigned ovmerlapplicant hereby a9rees to hold and <br />save harmless the City of Everett (rom any and all claims (or <br />damaqes, costs, exoenses, or causes o( aclion Ihat may arise <br />because of mslallaUon and maintenance of Ihe improvement <br />or olher right-of-way use hereto applied for and (uriher agrees <br />to remove same upon notice from the Ciry and to replace <br />pubiic property damaged thereby. <br />�,1�i.��f�,..� ��e,�,�,/ I I I �a i�� <br />SignatureotApplicant � Da!e <br />WORK AUTf10RIZED BY TIiIS PERMR P1U5T BE STARTED WRHIN 180 DAYS OF DATE PERM�T IS ISSUED AND THEREAFfER IS TO OE DIUGENTLY <br />PURSUED TO COMPLETION. THIS PERMR (�tAY OE UNCELIED BY THE CfTY UPON ANY $TOPPAG[ OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />