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PUBLIC WORKS Date ���a;=005 <br /> Public Works Permit a PW0504-061 <br /> PERMIT �°5°4-°b° <br /> Ouilding Permit M <br /> PUBLIC WOHKS DEPARTMENT Planning Re�erence# <br /> 3200 Cedar Strcet <br /> Everett,WA 1 Public"'orksFeeS 5�5.00 <br /> �425,z5�.� �n�rING <br /> Guarantee S <br /> OIYNER NAME P. 6 D FAF3i CT'.EEI{ LLC APPLICAIJT NAME <br /> nNDADDRESS�.FO EOX BZO ANDA�DRESS' <br /> CLINTON wa �azsu <br /> eiioNe 36U3914609 Ph10NE. <br /> TA%PARCELI.D.0 �j?Q�J,i0ii960005 PROJGCTADDR[Su'Q�il�� �iTH DF: So ��1�' h <br /> DESCRIP710N OF V <br /> FROPOSED WORK�. <br /> * RE.AF. SETBACF IS FEF. SITE PLAH. <br /> C:. . � b <br /> PERMIT CONDITIONS <br /> 1. All calls for inspedion shall be made 24 hours in advance -phone (425) 257-8810 <br /> 7. All work shall be perlormed in accordance voith tks permit and currenl City ol Eoerelt Design and Consiruction <br /> S�andards and Specifications. <br /> 3. Call Location Underyround Service 4A hrs. belore you dig. TOLL FREE NUMBER 1-800-424-5555 <br /> W` <br /> 4. Connect side �ewec per riry Standacd �601aftec sewee liYt sr.ation i� cotipleted and r <br /> � <br /> �����inve '^ <br /> 5. Conn�_•t C6PfLn�� +���unsF�outs CO i�lB �C81Odif@ .-�.}�SiBI� �CGYlt�2(� fOC th19 IUt. r:� +.t.i V/ <br /> . c� <br /> ���--�..-• t—r-r'��--• -� .1_ M <br /> ' W <br /> �.�� �%:Cf�� Kf�_ r��J]� 1: <br /> -" I CrJ:- T C1 C� O O <br /> � rFPi �,�c��: �� � <br /> (Ti r�'�,'- ,� <br /> C7 I-=`�" � �, <br /> e{,a i^�. F1�'_v ry �� <br /> V <br /> ��, � � <br /> rr'i <br /> a _ � <br /> �.h `-7 I <br /> O .» � f � <br /> r ' ; <br /> f rj n �. rn .���-.s.- i.n -' � I <br /> � �� �c.ir�iG r� n � I <br /> �(T� ._ i��' � ' � -'i � <br /> i�--�.n <br /> , �:_, a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> / � - / ' The und�rsiyned otena/applicant haeby agrees to hold and <br /> �- ��-/� �-C�l=�='�� S (� Q J� save harmless Ihe City ol Everetl Iro,m any and all claims lor <br /> n uuvea lor canstmction ,�:r damages,costs,ezpenses,or causes ot action thal may arise <br /> (1 because ol installation and maintenance of ihe impiovement or <br /> 1.' other riyht•obway use hereto applied lor and ludher agrces fi <br /> �i-�Vi: "�N '�� �'2z-C�� remove same upon notice irom the City and to replace public <br /> FINAL INSPEGTIO� (��— pmperty damaged Ihereb� � <br /> ApproveA a;Cnnslm ed Dale f, � c /r i'—N� <br /> /( ` <br /> —!1_ <br /> Signalure ol Applican� Date <br /> WOPK AUTHORIZED�V THIS PERIdIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUcD AND THEPEAPTER IS TO BE DILIGENTLY PURSUED <br /> f0 CO�dPL[TION.THIS PERMIT M11AV DE CANCELLED GY THG CITV UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />