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� 'Plication For " <br /> PUBLIC 1�. JRKS PERMIT Da� <br /> PUBLIC WORKS DEPARTMEP:T Public Works Permit N <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 guilding Permit# <br /> IYPE OR PRII�'T ONLY ^••�"^`"'-•4s Fee S <br /> Plan Check No: 3 53202 SEPA <br /> Applicat.Date: 10/14/96 <br /> Job Addre: 860b 1bTH AVE W <br /> Owner Owner: CITY OF EVERETT Phone <br /> Tenant: SPRINT SPECTRUM <br /> Proposed Uee: TELECOMMUNZCATIONS <br /> Deec. of Work: <br /> Applicanl <br /> COMMUNICATIONS FACILITY ON WATER TOWER phone <br /> Describe Proposed Work _ oFFICE ssx Jos sET � <br /> APPRVD FOR PERMIT: DATE_/_/_ BY <br /> � <br /> � <br /> �/ <br /> PROJECT ADDRESS(if krown) — M <br /> Attach four(4)copies ot plans for proposed work-Draw to scale and note ihe following if appllcaole: W <br /> •Property Lines •Outline and dimensions ol al:existing and proposed structures on ihe lot 'Existing and proposed utilities O <br /> •Centerline�f street •Indicate North •Show any prcposed grading changes •Show measuremenis � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PER�IIT CONDITIONS: <br /> 1. All calls for inspection shall be made 24 hours in advance- phone 259-8810. O <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> V♦ <br /> ':�^uc LvORKS P6NddiT O <br /> ����a���6� a <br /> _;.,_ <br /> rATL?__-� /� / -.�... <br /> � ���. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersiyned owner/applicant hereby a9rees to hold and save harmless <br /> the City of Everelt from any and all claims for damages,wsls,expenses,or <br /> causes of action that may arise because of inslallalion and m�intenance of <br /> ApprovedforConstruction Date iheimprovementorotherright-o!-wayuseheretoapptiedforandfudheragrees <br /> to remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Dale ' <br /> Approved as Constructed <br /> SignaWre of Applicant Date <br /> WORK AUTHOFIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />