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`7'f;Y� <br />���� . <br />� <br />OIVNER NAM1fE <br />AN�AUDHESS: <br />PHONE: <br />7A% PARCEL I.D.M <br />DESGRIPTION OF <br />PROPOSEO WORK�. <br />PIJ�LiC VIiORlCS <br />PEIRMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Ceder Strect <br />Everett, WA 98207 <br />(425) 257-8810 <br />,i c,:,,:;�•: �:�:�. <br />— - -.z_ _ <br />PERMIT CONDITIONS <br />Date <br />Public Works Permit +� <br />Building Permit q <br />Planning Referencn ," <br />Public Works Fee 5 <br />Guarantee 5 <br />APPLICAN7 NAME �. _ -. ,� ,. <br />AN�AODRESS: .. _ : ... � .,..:.' J..I' .: �I �:���� <br />.. <br />�� <br />�. � i'OS I 111!`l•i..� ............................ <br />PHONE: <br />PRQIECTAGDRESS: . <br />i. All calls fer inspection shall be made 24 hours in advance. <br />2 All work shall be periormed in accordance with this permit and curre��t City of Everett Design and Construction <br />Slanoards and Specificalions. <br />3. Call Location Underground Service 4[3 hrs. befure you dig. TOLL FREE NUMBER 1-800-424-5555 <br />_ l ,•„ , i = t r.,._ .3i :: _�:; ; <br />_L�-� 1D❑ !'�3I1tL 1�u ,9 IIC� j� Y � lt� Vf �VPL�9tY fYqlt<]dLdO L L <br />a�.at�d r,a Jri � fr m fottnd:�ticn, .,_:1u�+Uc an! i< <'?w�,� :ha71 <br />..j'-i� paC!71=^aj .�-*''-. i'<= .ld`Jt1t1Q nf G3L�L't�3Z i3 3�'�+W�'j ^I7 t�ll'] �.'LL l�l�i:�3 '- <br />�'i1CT_r ihU•�� Ln=t:S' OT' ilut�l"13 i.0 k�e tca.�ged OTIY^ Yi�3i�Vi]�. <br />I��17.1(a.lil�3 7[Ic7Y�sC).319 hi: {:�c �tiCK�tf p❑ 71�ia•Aaik9 dll�i :71�7�'.d31.{CF. Y�7 �?�' hF_�tT l'.j�-, <br />- ffi[ I�.F•rjZgY.Y.�i3ft tC%firF-_t. <br />'�i�r y?:rC i::=L?C :�'i% 1�� ?J'..�y.} giijF��d�:f_ '}L'S<j5. <br />r.bi �V�' 3J1•:� !'c'C�19:'� �.UY��� 711i� _I an� ��.i=v,i}: as F.�e1'- !-12V UZ L\ro�:.�t __,ri,l;r':.: .. <br />7n5t ,.n�, .:n rhi� rt n„�al':7 iC�:nt3ry•� �S tit«:Ctr-9 liy 'lie Y�ahlx�: : <br />S'- ZQ-�� <br />FINAL INSPEGTlON <br />Approvetl as Consimcted <br />� <br />F�CKNOVJLEDGE64ENT OF CONDITIONS <br />The undersigned owner/applic�nl hereby agrees to hold and <br />save harmless the City ol Everelt from any and al claims lor <br />damages, costs, expenses, or causes of action tha! may arise <br />because ot installation and mainter.anco of ihe in�provement or <br />other nghl-of-way use Y,ereto applied lor and funher agrees (o <br />remove same upon no!ice irom Ihe Cily and to replace public <br />proporty dr�maged Ihereby. / <br />i —7� <br />/�-��.1.`�/7,,;✓ `"'i� / �Z�`�C'T <br />Signatum oi Applicar� Date � <br />: <br />170RK AUTHORIZE� BY THIS PERMIT MUST BE STARTED WITHIN 18�' JAYS OF DATE PER1.41t IS ISSUED AP.D 7HEREAFfER IS 70 BE DILIGENTLV PURSUEU <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLED BV 7HE CITV UPON ANY S70PPAGE OF VlOFN ON TIIIS PROJECT OVER 90 DAYS OURATION. <br />1-PVlP (]/O6) DN7A�AR. INC. <br />W <br />� <br />V, <br />O <br />� <br />O <br />V! <br />O <br />a <br />