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PUBL1� WORICS <br />PEF�MIT <br />PU6LIC WORKS UEPA9TMENT <br />3200 Cadar Street � <br />Everetl, WA 96201 <br />(425) 25�-g810 <br />AfJUAUUHE55: —' ' "" ' - ' �' '� �' <br />....,. .-.. . . �-�'.Y ... <br />_ - - -;= ;:�:T r.z <br />-:,� - <br />PHONE: - - <br />TAX PARCEL I.D.N _ <br />OESCFlIPTION OF . _ . .. _ . . - <br />PROPOSED WCHK: �� - - - � - - <br />•rLllif <br />ANDADI <br />PHONE: <br />PROJECTADDP.ESS� <br />Date <br />Public Workt Permit # <br />Building Permit # <br />Planning Relerence # <br />Public Works Fee ,f <br />Guarantee & <br />TO POSTING.�}���[.�r.�:.7..... <br />PERMITCONDITIONS ° �` " <br />t. All calls for inspection shall be made 24 hours in advance. <br />2. All work shall be pedormed in accordance with this permit and current Cily of Everett Design and Conslruction <br />Standards and Specifications. <br />3. Call Location Underground Service 40 hrs. belore you dig. TOLL FREE NUMHER 1-800-424-5555 <br />.-- . .-=ct :�f.. _: n ._ . -. <br />. :nvraii eev.-�ion �:ontr.oi me.3s�.tce: a�: d•:.tann�:.�.� . � . . .. _ .._ . <br />� ilt fem^�, .�t. as� bs,1F�, :;wil�s nr. �[c;�ion h: :r;; � ' ,. <br />.::?RCVE aCC�.�il�:❑ '-^Il`CC�Z a�3'.�lC!iS IIj?n% CGIC(�ZP_`1J�1 02 �`.f5•=. �iC�'tjcr' N.C1.:C tn :iC=._ <br />. �_OV31 :�Z t}7C T�oL'1h1C. <br />ii ex_avtit�:i m::t�e;ti] irnm tr,iind�tion, �.icfevalk and •:3_•iveuays shall be. bc;�:-:. <br />ppcc�;�;�+, �,:-e!ni.tC�d vite. `«:: va^ti:u- nf tnat:eeial i� aTlr,w=3 nn rhie, },uil,iir <br />n_ :i1Ti 'IUa. �OCi:S C'�L' .i.D��S.': tO t�2 r1'3ri:�C C�IiC: Ii�diiP)Sfl. <br />. ��O �ii}�L�i:Y1 rn�Crri319 h�: j�r_ :�'=3�7E'�?Q ��❑ Si�]a5J3�ni 3ll�j Si��P:li':"' __ . - .r . .. <br />. .. -�1?;%; fpC� i1F ....ri'1..9❑ t.ClVc..l. <br />.. � •. ,�.�Y 73,.t,_.1� F,:•>: Z" .ii.iJVr• :'.lrlr.: , SY _. ,.. . <br />::�ew•a7 irc-r,� the p!._,F,�_.ty ,i�:. . _ <br />. .. . _.�. _"_ '. .'...__ r_. F)� ._.. .. . <br />f/ <br />�-- ACKNOWLEDGEMENT OF CONDITIONS <br />.� /� ' Th� untlersigned ownedapplicant hereby agrees b hold and <br />} /�,� �, �„ � (// n / save harmless the City ot Everett from any anA all claims for <br />a✓'/l �. C: .� .. c : ��/�' '._� / �'1� k' <br />—� damages, cosls, expense;, or causes ol action Ihat may arise <br />Ap oved lor Conslmclion Daie because ol instailation ar�d maintAnance ot ihe improvement or <br />- ? ,r ,/� L o�her right�obway use here�o epplied lor and lurther agrees to <br />� f(- -, Z� C remove same upon notice Irom Ih Ciry and t replace public <br />-' FINAL INSPEC ION p rty da geA Ihere . I ((( <br />Approvetlas onsimc�ed Date ' � J f� �� <br />l <br />_ S! �ature fApplican� D te <br />WORK hUTHORIZED BY 7HI5 PERMIT MUST 6E STARiED WITHIN 1B0 DAYS OF DATE PEPMI7IS ISSI�E NDTHEREAFTER IS TO BE OILIGEN7LY PUFSUED <br />TO COMPLETION. 7HIS PERMI f MAV BE CANCELLEO BV THE CITY UPON ANY STOPPAGE OF W�JRK ON TNIS PFOJECT OVER 90 DFYS DURATION. <br />eNwv ianei OPrn...- <br />W` <br />r <br />� <br />N <br />W <br />y <br />� <br />Z <br />4 <br />� <br />� <br />! <br />