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I�UBL1��. �PV�IRKS °
<br /> P�R iVl l T Public Works Pcrmil q
<br /> Duil9ing Permit k
<br /> PUL' '^WORKS DEPART64ENT Planning Reference N
<br /> 3200 Cetl�r Slre^I
<br /> Evcrett,WA 98201 Public Works Fee 5 -
<br /> (425�157-881�1, FfO�TI1YG Mf{P '
<br /> � � 1 9 •.� � Guaraniee 5
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<br /> OIVNGR NAM[ -' ' . •...; �: , ' . . .' . . �'--' dPPLICANT NAME
<br /> ANU AODRESS�. , , .;:(? : , , , APJD A�DNFSS:
<br /> PFf04lE�. � � � PHOP'c:
<br /> TA%PARC[LID.a "' � ' �� " PFOJLC7A7DR[55�. '� �-� �
<br /> D[SCRIPTION UF "� � �
<br /> PROPOSED�.NORK:
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<br /> PERMIT CONDITIONS
<br /> t. All calls lor inspectior sha!I be made 24 hours in advance-phone(425)257-8810
<br /> 2. All work shall be perform?d in accordance wilh this perTit and current City ol Everelt Design and Con,tr_iction
<br /> Standards and Specifications.
<br /> 3. Call Location Underground Service 48 hr� Lefore you dig. TOLL FREE NUMBER 1-800-424-5555
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<br /> i:: -i7t fence, �Lca��r Lale... .:vales, �c r-_r �s�.��> L�l�nk,ts.
<br /> 6 /��'Ef l.��,fl� �fh� f��6�:e �do.�F`.t />>��ecfur �r,ar fo S�a.- ` �
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<br /> pC1'n�d . .
<br /> ACKNOWLEDGEMENT OF CONDITIONS
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<br /> ` r� '. - . ,: � �. The undersigned ownerlapplicant hereby agrees to hold and
<br /> 1 !!�}; � ��L- � ,�-,'<' '�� save haimless the Ciry of Everetl lrom any and all daims tor
<br /> AfP'�vetl lor Conslmclwn ;' Date ! damayes,costs,ezpenses,or causes o�aclion th2t may arise
<br /> % because of installation and maintenance ol the improvement or
<br /> other right-ol-way use hereto applied tor and further agrees to
<br /> remove same upon notice irom Ihe City and to replace public
<br /> FI�AL INSPECTION propetly,damaged thereby. ,
<br /> arprw��da:Consiructea Dale �;� r' - -"
<br /> j. . F-..
<br /> Siynalure of Applicanl Dme
<br /> WORH AUTHORIZED Bl'TMIS PERMIT MUST OE STARTFD V1ITHIN i�p DA:'S OF�A7E PERMIT IS ISSUED AND THEf1EAF7ER IS TO BE DILIGENTLV PURSUED
<br /> TO COtdPLETION THIS PERMIT MAY BE CANCEI.LED�Y THE CItY!:PON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.
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