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Pue�ic woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sireet <br />Everett, WA 9B�' 7 <br />(425!25,:ppo ppSTING <br />OWNER NAME � A� <br />ANDADDRESS: 3ZO7 LO4� PL SB A� <br />SVERETT RA 98208 <br />PHONE: 425379���6 <br />iAX PARCEL LD. N O ZOI <br />DESCRIP710N OF �O �%U� <br />PROPOSED WORK: <br />PERMIT CONDITIONS <br />JUL 2 1 <br />PHONE: <br />NAME <br />Date <br />Public Works Pertnit R <br />Building Permit 8 <br />Planning Reference u <br />Public Works Fee $ <br />Guaranlee S <br />3; 22/2004 �" <br />P�0403-021 <br />C0403-029 <br />$25.00 <br />6 21ST �VE W NLOT 3 <br />1. All calls (or inspection shall be made 24 hours in advance • phone (425) 257-8810 <br />2. All work shall be performed in accordance with lhis permit and wrrent Ciry of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. befora you dig. TOLL FREE NUMBER 1-800-424-5555 <br />9. Connect �ooftop downspouta to the dcainaqe ayatea pcovided for thi:� lot. <br />5 install erosion control ieaaures as detenined by the Public ilorka inapectoc, such <br />aa ailt fence, etcaw balea, avalea, or ecoaion blanketa <br />6. Reaove erosion control iea�urea upon co�pletion of the project prior to final <br />appcoval of the pecait. <br />7.A11 excavated aatecial froa foundation, aidevalk and drivevaya ahali be hauled to an <br />approved, permitted site. No vaating of ■aterial is alloued on this building lot. <br />8. Contact Mukilteo fiatec Diatcict foc connecting pcoviaiona fo[ watec and �ewec <br />services. <br />, ` l�i� � a¢ o �- <br />A mvcd lor ConStmttion Date <br />_ Ke� � ���� <br />FINAL INSPECT ON <br />Appmvetl as Constmctetl Dale <br />�;a-��-'6—(�.4 <br />!! <br />:�Up.LO�+ <br />JRCIIV <br />1!'c(:k� <br />°WMS <br />C�R� VE <br />"F OTAL <br />,� =,, <br />4����i�'. <br />LI JO. �` <br />� ,. �'J <br />bG.O,� <br />°?.00 <br />2�,co <br />1.?3l : 0.`: <br />= i)'17�0'_ <br />W <br />� <br />�'A <br />V/ <br />W <br />O <br />� <br />Z <br />O <br />� <br />N <br />O <br />a <br />6_:!-4r.i-', �.�'=_..Q� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownerJapplicant hereby agrees to hold and <br />save harmless lhe City ot Everett from any and all claims for <br />damages, wsts, ezpenses, or causes ot action that may arise <br />because of installation and maintenance of Ihe improvement or <br />other right-of-way use hereto applied for �nd lurther agrees to <br />remove same upon notice Irom ttie City and to replace public <br />property maged thereby. <br />�N+OII/ 3 ��J � � <br />Signalure ol AppliCant Date <br />WORK AU7HORIZED BY THIS PERMIT tAUST BE STARTED WITHIN 180 DAVS OF D.47E PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PUFSUED <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLED DV THE CITY UPOI. ANY STOPPAGE Of WOFK ON THIS PROJECT OVER 90 DAYS DURATION. <br />