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/ � <br /> Date „/� ���:ipi�.i . <br /> pUgLICWORKS publicWorksPermita pW02G�"�1�t. <br /> PERMIT �`. <br /> Building Permit a <br /> Planniny Reference a <br /> PUBLIC WORKS DEPARTtdENT ` �� ��i� ��II � <br /> 3200 Cedar Street nu6lic Works Fce 5 � � <br /> Evcrett,WA 90201 <br /> (425)257-8810 Guarantcc 5 <br /> pPPLIC�NT NAME ' <br /> OVJNERNANE JI-Ni �-'���==hOP7� ANDADDRESS'. ' <br /> ANDADDRESS�. LI��'�r iT^ f1�:'E ;-..- .� <br /> .. ...� , . ,_..: ..r.,.; PHONE�. <br /> PHONE. .•�- ' - . -. <br /> PR�JECT ADD(i[55. �. �I Y1� k t- ( CI.��.S" �J���J e <br /> 7AY.PARCELI.D.p <br /> U[SCRIPTION OF -.-�- � ' • - �' ' ""' <br /> pRpPOSED WORK: <br /> PERMIT CONDITIONS ; <br /> 1. All calls tor inspection shall be made 24 hours in advance - p��one(425) 257•8810 <br /> 2. All work shall be perlormed in accordance wilh this permit and curreN City ol Everell Des�n and Construction � <br /> Standards and Specihcations ^0-424-5555 � <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NU��BER 1-n� � � <br /> , , � ..A _ . �. <br /> � _.. �j, ,i, � �r �_,_. e <br /> _ .. i... ,. .-�' . . .: � � . . :ii. \��L�� //� <br /> .. �. . _� .. . ... . � /� Wl�����' ' �'�t2�0µ��' \V� �J4^Qu' �// <br /> � . pK -� P� .�w K9 �-p� �p' ���v ��-� g�'3�o2, m <br /> Dk 5��2- j�a.'� �v0�� `N '�'` a��ITCaT�ys�i' + � <br /> 7 <br /> . Z <br /> �, _ 0 yp <br /> 1 .... . A`�` _�, 11 <br /> 1.. _I <br /> �� , _ O <br /> a <br /> AGKNOWLEDGEMENT OF CONDITIONS <br /> � The undersigned ownedapplicanl hereby agrees to hold and <br /> ���.-U save harmless the City of Evcrett irom any and a!I claims fo� <br /> � dama9es,cosis,expenses,or causes ol action iha'.may arise <br /> Appmv or Co,simc�on � ���" Uecause ol installation and maiNenance of Ihe improvement or <br /> r other right-o4way usc herclo applied lor and fudher agroes to <br /> ,/ ,/ ,� �;`L�/ �J _�—Q _ remove same upon notice Irom�he Ci�y and�o replace public <br /> C%/! l.. -l. [ pmpedy dama�ed therebY. - -- — <br /> _J="y'— . <br /> FINAL INSPECTION oa1P �� � <br /> qpproved as Conslmr.led �� _-- � <br /> SiqnalJ�fe ol Appl� Daie�' /•� �dd <br /> TJO COIdPLEOONETDH SYPERMTE�AY BE CANCELLED 6Y THE CIN'UPON ANYO S OPPAGE OF�^10RK10N TIilS PROJECT OVER 90 DAYSIDUR TIONPURSUED <br />