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. <br /> PUBLiC WORKS Dale ��/�a/��U1 � <br /> PublicWorksPermit#PWU11U-G::;: �.�+� <br /> PERMIT B�llo-04 � ' <br /> Building Permil p <br /> PUBLIC WORKS DEPARTMENT Planning Relerence q <br /> 3200CedarStreet .�,�,�� i„�,, <br /> Everett,WA 98207 Public Works Fee S �j <br /> ��2�5��1 N G ocT o � zoo2 ��s. 1 M{t� �2-I o0.oa ' <br /> OWNERNAM�JST R1TE CUb:STP.UCT10P1 AHhuCnNTNAM��3ST RITE CJNSTRUCTIOC7 i <br /> ANOADDRESS ANUADDRE55: <br /> PO BOX 204 "s PO BOX 3043 <br /> EVERETT I4A 53�03 EVERETT WA 98�03 <br /> „_;,. �-, - <br /> PHONE: ( 4?�i � SO£—,:y?79 PHONE: ( 4;;5 � 311a-31_79 • � <br /> _... .. � <br /> �., <br /> 7AXPARCELI.D.p l���l�a��l?��OV`�' PROJECTPi1D9ESS:�j> >4 ST:H AV� I^1 '�- " <br /> DESCRIPTIONOF i.7EW TR�YLEX � ' � " -" ' <br /> PHOPOSED WORIC' .,:A,,•'...- ... .. <br /> P4J �� ,, , : <br /> rL - _ : .. <br /> ":�i E_ <br /> -� . . ., . ... ._,ou <br /> pERMITCONDITIONS , :j-_r•,,}; <br /> 1. All calls for inspection shall be made 24 hours in advance-phone (425) 257-881G :.� ._ `��`� .:��_� <br /> 2. All work shall be performed in accordance H•ith �his permit and current City of Everetl Design and Gonstniction <br /> StandardsandSpecificalions. �'`=� ��'.!: � <br /> 3. Call Location Underground Service 48 hrs. betore you dig. TOLL FREE NUMBER 1-800-024-5555 ' '_ _ _ � , <br /> 4 . As p�r ���.,pi�ved ni.aii rlat ��d ].0/25/pl . . L <br /> 5, Cc,nnec-E Cp� ;�, dr"�vP,wc� �o �ew or ex�s���y G6 ;� ad,-wts . � ; <br /> �, KFG�7 Gi�il� 5-�CG�s G 14.�1 �� Ta�I '�r�'�7Gf dt!✓��q CU'� 5'�'��SjD'11 M . <br /> 7. pr�v�ewa� 'Sha61 lx a.s �Gf G tr� 5�� �� �3D$. Q <br /> �. � �ir,� ��J I7� u/G�ri�S 1��o� �r�v� -� �M n I� t�io/I:. -�a� � ; <br /> �� �GOn y�r.�(�'�'c�1 ✓v�C(k��S-- �I�c 339''7`�-. z �� <br /> (,� � �� rc>� off M�s� be d;scrtArr�ed �G � r�Fdow�s��o�fs � � <br /> 1�i�����'Gi�or SyS�.nr� � Gi� � �vP�'� 5'�W✓►'I W�'�' �1A►1�,� <br /> 3 —z ,�, z. o O : <br /> I,U, Si�e,S�u��,' Sha►� � t�sP�✓ �� s�f-'�.-nd�-d ��aol, (�oZ �G�{.. a <br /> � <br /> � <br /> �` <br /> ACKNUWLEDGEMENT OF CONDITIONS <br /> G�. Iy'� �e O The undersigned owner/applicant hereby agrees to hold and <br /> l/ J� I save hannless ihe Ciry ol Evcretl from any and all claims tor <br /> pproved ior Cons uaion Ua�e damages,costs,expenses,or causes ol action that may aris� <br /> y because of installation and maintenance of the improvement or <br /> [!�� �% /p.Gt � ' � other righ4ol-way use heraio applied for and further agrees to <br /> _ i �M1 :� l��w-'�'� ��,� —a �2. remove same upon notice trom the City and to repiace public <br /> FINAL INSPECTION propert dam ereb� �., <br /> Approvetl as Constmctetl Date ��'�? � �.1 � <br /> J (J � <br /> Signature ol Applicant Dale <br /> WORK AUTHOFIZED OV THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PUR3UED <br /> TO COMPLETION.THIS PEFMIT tdAY BE CANCELL[D BY THE CIN UPON ANY S�OPPAGE OF WOiiK ON THIS PROJECT OVER 90 DAYS DURATION. * � <br /> i <br />