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PUBLIC WORKS <br />PE�MIT <br />� <br />PVgLIC WORKS DEPARTMENT <br />3200 Cedar Slreet <br />Fvpre��, WA 98201 <br />�4zs� zs�-e�g, FO) i I lV � JUL 3 0 <br />U <br />uwrven iw�mt'F'j,i�};f� i;�_��;5 ;jiC <br />AND ADDFiESS� <br />Fo sc�:: aaa <br />�k� ���-�.r��� .. <br />PHOWE: :j�F�SU�%�;% <br />TA% PARCEL I.D.�I�� 4 i � i fi ;1 ` i 1 l'� �?; <br />DESCRIPTIGN � y,�,;!: r. - - <br />PROPOSED WO �. " ' "` "'"' `' ' <br />PERMIT CONDITIONS <br />Date i; •i;=.,�i�; <br />Public Works Perm��9;��F,p�-(�i)" <br />Duilding Permil p Cp �:� )_ - . __ <br />Planning Reference # <br />Public Works Fee S - - <br />Guaramee S <br />APPLICANT NA�AE <br />ANDADDRE55�. <br />PHONE�. <br />PROJECTADDqESS. . <br />. . _ _ .. -" P:�. u: � - � -- <br />-'-- �t' ="—'�YFi:ti�_ "'F::.S': <br />t. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br />2. All �vork shall be performed in accordance with this permit and currerl City ot Everett Design and Construdion <br />Standards and Speci(ications. <br />3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800-424-5555 <br />4. _ nna:': : . _ . , _ , _ . _ . �� . , . _ . _ .. <br />-. . nne_t , �� _.F � , �._.,�. -h._ ..l!: �n; i -�[,.. F _. .. --- _ _ ,�. <br />. �nr:1 , �.. -i .�,�. . r _ . . .. _.. , � �,i „ 'n � <br />. i:�. �_. .. �l' _. � .. . ;�:��_ ._!, .-.. . <br />... .._. 'if_ , . :-. ... � .�_ , . _._... '_'1". ... <br />'� I � <br />�'i � ( <br />Appmved as Conslmded <br />ACKNOWLEDGEMENT OF CONGITIONS <br />� <br />� <br />� <br />O <br />� <br />Z <br />O <br />F- <br />� <br />O <br />a <br />The undersigned owne7applicant hereby agrees to hold and <br />save harmless the Ciry of Everett from any and all daims for <br />damages, costs, ezper.ses, or causes of action that may arise <br />because ot installation and ma�ntenance of the improvement or <br />other right-oFway use nereto applied lor and furlher agrees to <br />remove same upon no�ice Irom �he City and to replace puhlic <br />�pmp feged ihe by. <br />_�� 3��� _. <br />S�gnaWre ol Appliw�t Oale <br />CJ(Y.K AUiHORIZEU 6v TFIIS Pf-R�dIT NU.;T i3E S7AFT[D NJITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO 8L DILIGENTLV PURSUEED <br />TO COrdPLGTION. TbIIS PER1.tlT h1AY GG GANCELL[0 �Y THE CITY UPON ANY STOPPAG[ OF WORK ON THIS PROJECT OVER 90 DAVS �URATION. <br />