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� <br />�� <br />PUBLIC WORKS PERMIT Date: <br />City of Everett , blic Works Public Works Pe�mit #: <br />32�dar Streeqr�g�`'�1��Hu> 10:48 Building Permit #; <br />everett, Wa ss2o1\Ef-1 6?7b59 <br />CT R�anning Reference #: <br />4/13/2010 � <br />PW 1005-01' <br />(4?�)��S���A�I� Public Works Fee $: $ 495.00 <br />1 OTh�k ._ ��95.00 Other �: <br />OWNER NAME AND ADDRESS: 6^�CK <br />NELSON FAMILY PROPERTIES LL <br />22422 STATE ROUTE 9 NE <br />ARLINGTON Vyq 98223 <br />PHONE: 4253539701 <br />PARCELID # 2$051800307300 <br />DESCRIPTION OF PROPOSED WORK: <br />INSTALL OIL WATER SEPERATOR <br />NELSON PETROLEUMIPACIFIC PRIDE <br />�I�AL�aNT NAME AND ADDRESS: <br />s�'���oo <br />PO BOX 2071 <br />KIRKLAND WA 98083 <br />PHONE: 2064595775 <br />SI7E ADDRESS: 9826 7TH AVE SE <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hours in advance. <br />2. All work shall be performed in accordance with the permit and current City of Everett Design and Construction Standards <br />and Specifications. <br />3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 � <br />4. CONSTRUCT PER APPROVED PLAN 6/24/2010 <br />T.► �,.�T�.�.. io I`i io <br />iv rv�iu�u <br />N� p�>r;w� /�c�e.el <br />W <br />H <br />� <br />� <br />�Q <br />O <br />� <br />F <br />� <br />a <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/appiicant hereby agrees to hold and <br />save hartnless the Cily of Everett from any and all claims for <br />damages, costs, expenses, or causes of action that may arise <br />because of instatlalion and mainlenance of ihe impravement <br />or olher ric,ht-of-way use hereto applied for and further agrees <br />to remove same u on notice from the Cit.y and to replace <br />public property d�m gec�l�ereby. <br />of <br />Date <br />WORK AUTHORIZED BY'TH;S PERh1lT MUST BE SfARTF.D WI7tiIN 180 DAYS OF DATE ERDiR IS ISSUED AND THEREAFTER IS TO BE DILIGEMLY � <br />PURSUED TO COhiPLETION. THIS PERhiR P1AY BE CANCELLED BY THE CRY UPON AN STOPPAGE OF WORK ON THIS PROIECf OVER 90 DAYS DURATION. <br />