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PUBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />4:7T (425) 257-8810 <br />OWNERNAME Kevin Aldrich <br />AND ADDRESS: 10127 21st Avenue W <br />EVERETT WA <br />PHONE: 4253558432 <br />98204 <br />PHONE: <br />Date 4/22/2005 <br />Public Works Permit a PWO504-048 <br />Building Permit If <br />Planning Reference If <br />Public Works Fee $ $25.00 <br />Guarantee 5 <br />TAX PARCEL I.D.N IPROJECTADDRESS:1(1127 21St Avenue a <br />DESCRIPTION OF <br />PROPOSED WORK: <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hours in advance -phone (425) 257.8810 <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800-424-5555 <br />4. Contractor to meet with the city inspector to discuss work prior to beginning <br />construction (call 339-7404). <br />5. 12" pipe shall be used - the material shall meet city standards for cover <br />requirements. m G7 <br />n. All bedding and backfill shall be crushed rock. <br />7. A C.B. may need to be installed in conjuction with this projectS4 pztt*24th;he <br />public works inspector). 3> FF9 �Fj <br />2 <br />m �ro <br />r <br />r� r_ <br />r::r <br />G <br />Approved as Constructed <br />Date <br />Date <br />�-3G-vG <br />fA G. <br />YT �n <br />11 <br />r •Z�•13 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless the City of Everett from any and all claims for <br />damages, costs, expenses, or causes of action that may arise <br />because of installation and maintenance of the improvement or <br />other right-of-way use hereto applied for and further agrees to <br />remove same upon notice from the City and to replace public <br />propey amaged e eb . <br />y <br />Signalure of Appl ant Date <br />LW <br />r <br />V/ <br />Im <br />0 <br />Z <br />0 <br />F_ <br />0 <br />a <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />