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� <br />� <br />PHONE: <br />TAX PARCEL I.D.K <br />PUB��c woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everetl, WA98201 <br />(425) 257-8870 <br />�•��'"�'L�2.L AN7'Fir�NF <br />97L 58Tli PL W <br />Mr_rf(ILTEO WA <br />APPLICANT NAME <br />AN�ADDRESS: <br />98275 <br />PHONE: <br />PRQIECTADORESS: <br />DESCRIPTION OF <br />PRGPOSEDWORK: Ff,'MODEL-CAAHGF IfSE TC� S(tSIRESS PRR3i <br />PERMIT CONDITIONS <br />Date <br />Public Works Permit �Y <br />Building Permit # <br />Planning fleference # <br />Public Works Fee S <br />Guarantee $ <br />`;19i�Or� <br />aW0ap5_p"' I <br />soFc�a-o���l�,y,;� <br />I� � <br />1. All cails for inspection shall bs made 24 hours in advance. <br />2. AI� work shall be performed in accordance with ihis permit and current City of Everett Design and Constr�ction <br />Standards and Specifications. <br />3. Call Locstion Underground Service 48 hrs. be(ore you dig. TOLL FREE NUMBER 1-800-t24-5555 <br />Y. i-7111:=�:' COqitO(i �jry.Jllg�p�lt5 t�? t�10 dC37.f13gE aysrem �COy1��N�� f�'�L' `�1].9 l,.r <br />5. No .�irt, mud, r��cks or debris to ir_ tracked onto L'L�3dM3}' <br />� �r3��crc.�.. v� 9 oB <br />rovetllorCor.stmclion D.y <br />cd orr< se'�"11 dO.✓�yG�7�� — <br />Dato <br />$45.00 <br />�p,, � � �G� <br />C7—a'-�' �: r, �-, <br />r..- '"' <br />� _a <br />� r-. i.� <br />T � <br />1 <br />b'� <br />N <br />f� <br />.sr'.�J . v, <br />. � o �� <br />�� ° �� �i <�w r <br />�, �.; � � �„ r. ;.., <br />�. <br />�.,; t. i ;-;. , ,, ", - <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownedapplicant hereby agrees to hold and <br />save harmless the City oi Everett from any and all claims for <br />damages, cosls, expenses, or causes oi aC:ion thal may arise <br />because ol ins!allalion and maintenance of ihe improvement or <br />olher right-ol•�vay use hereto applied br and furthEr agrees to <br />remove same upon notice from the City and to replace public <br />property damaggd {hereby. <br />I �o-.O<f'/O I .i_.��,1%. � Li��(/_(/U'`�r/J�-----'�-- \ <br />SignefureolA nt Date \ <br />WORK AUiHORIZED BV THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF OATE PERMIT IS ISSUED ANO THEREAFfER IS TO BE OILIGENTLV PURSUED( /� � <br />TO COMPLETION. THIS PERMIT MAV BE CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS PRWECT OVER 90 DAYS DURATION. <br />EP1YP (7/O6) MTABAR. ING `" <br />/ <br />W` <br />r <br />'�A <br />V/ <br />W <br />O <br />� <br />Z <br />O <br />r <br />N <br />0 <br />a <br />