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OWN[RNAME <br />ANDADDRE55: <br />PHONE: <br />TA% PARC[L I.D.N <br />DESCRIPTION OF <br />PROPOSED WORK: <br />PUB�ic woRKS <br />PERMIT <br />PU�LIC WORKS DEPARTMENT <br />3200 Cetlar Slreel <br />Everett, WA 98201 <br />`"z5,25'-�'� POSTING._��r i � <br />PHONE: <br />PROJECTADDRESS: <br />Date <br />Public Works Permit N <br />Building Permi� N <br />Planning Roterence p <br />Public Works Fee S <br />$ <br />PERMIT CONDITIONS _ <br />� �{��,v�n�v3 <br />1. All calls lor inspeclion shall be made 24 hours in advance. ��?�,c ls CL,i <br />2. All work shall be performed in accordance with this permit and current City of Everett Desi n antl�G�nstruchoriU� <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FRFE NUMBER 1-800-424-5555 <br />_.. �' .- .. .. .0 . '.... � _.1. . . _ �. .__ ) IL 1 �, 'S. ... .. <br />._L =..�nir�.T��. i:7��T:IAL b'b.C{t = !'!hu.`.T_�,t�, lT_[1P Z.✓Y.. : �i t�T._... .i. �if�=. _ .. _ . . <br />.7'ti:i1G'FC�� i�6�F!I'I`%1: �ITF. � P.IA`'�T.i1A; C.r hiA'I'��.:Ai, IS �.§LL��3.'F,tl ON�TF?F i lrrr--,.. .. .. <br />n �7n �rY••_.• .T,� nv., _ •� r:.,,. <br />i�=.. S,_ F...r.:> qF: D�E1._. ••: uc :ri�.:AEL :�iiT•. N�i�ilar(. <br />. �trli.PI2{p hii�.�T:T_1T�.L.'> 1�) _�'.� `i:=.�.�T� tJii `aT_L�Lk� V: r.i�J 'aT_L�Li�.'1.�$ iL� �_ '�:`� : . <br />, Fi'r� F£r��'ci•?TAJ '!-.i:v'F,i,. ., ., . <br />�citg It!��r"'."l�.c, jc, r_�rr.r r,m q_4-_:;a-'7Y',�i <br />� � _ .� <br />� - <br />�'.r � <br />_ ,, �.' . ;,i..l= �. �_ <br />Ap' ovetl lor Cons�mclion Dale , <br />a, <br />Oaie <br />`� -z/ -n <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicanl hereby agrees to hold antl <br />save harmless tho Ciry ol Everetl Imm any and all claims for <br />damages, cosis, expenses, or causes ol action that may arise <br />because uf installalion and maintenance ol the improvement or <br />other righFo4way use hareto applied lor and IuAher agrees to <br />remove same upon notice Irom Ihe City and to replace public <br />property damaged �heiaby. <br />(i'lC�llu1'l.t- l y�5�ti 3 � �• �`7 <br />Signaluro olApplicxnt D�te <br />WORKAUTHORIZED �V THIS PERMIT MUST BF STARTED �'JITHIN 780 DAYS OF DATE PERMIT IS ISSUEDAND THEREAFTER IS 70 BE DILIGENTLY PURSUED <br />TO COM1IPLETION. THIS PERMIT MAY BE CANCELLEU BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVEH 90 OAYS UURATION. <br />EPWP p;OG) DATABAR. INC. <br />�� <br />W <br />� <br />N <br />W <br />O <br />Z <br />O <br />/r� <br />V/ <br />O <br />a <br />