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►�UBLIC �IVO�a(5 <br />PERiVIIT <br />PUBLIC l'JORKS G.PAf��R�,1ENi <br />3200 Cedar Slreet <br />� 6eere�L WA 98201 <br />1425) 257-A810�... � O �nos <br />�'1 f' i�9 � I I 1`l d� �llll..�— `� <br />ol'1rdEH Nn�Ai3,�.h�.I.Fi1ip H(Y•fE5 <br />nP1D AUf)RES <br />�i� pi�): htib <br />LAKE STE'v�11S <br />i�nove: 92535o77u7 <br />�n��naceuo a U128n420i�6�7iip <br />lA ?8?°:"0 <br />nesc�amriouor- 1fEW AGIIJE - LY.JT�� ���II <br />PI90POSED WORK- <br />PERMIT CONDITIONS <br />APPLICAPJT N�IdE <br />ANDADDRESS: <br />PHONE <br />Date !.::i�?/�fjG: <br />Public Works Permit p tC�U512-040 <br />Buildinc� Permil # <br />Planning Reference # <br />Public Works Fee $ <br />Guaranlee 1 <br />��'0512-Od5 <br />PROJ[CT ADDRESS��'i U� 6Tf: DF. i: #LOT .::. <br />S2F.n0 <br />1. All calls lor inspection shall be made 24 hours in advance - phone (425) 257-8610 <br />2. All work shall be pertormed in accordance wi�h ihis permit and curreni City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 nrs. belore you dig. TOLL FREE NUMBER 1-800-424•5555 <br />y. C�_nr�ert .;:d� sewer p�c C�Sy ii?and.scd 5•s n�il� r'.�i<, i�i;. <br />°•. C��nnect cu��ftop downspouts t�, th� drainag� systam piov�_.:i_�.:I ,_. th_., '_>,. <br />C�. II15i31L ECiigi��❑ COflit%n IIIEd::111�i d5 f�B}:ECIQIIIH�7 �i� t�1�- i'11._i_•� :L�:t: 1!1SL�•'.'{.��r, .;II::II <br />.-f;: `•ilf f_I _ , ��2'.. ��<i� :� ...411 . 'JC 'L .. ,. t*__�1`� �... <br />� <br />7i <br />nppro or Gonslmclion Dale � � <br />�, ; �lf 7 /� c'� <br />—1NAL INSPE ION <br />Appmvetl as Constructed Oale <br />ACKNON,'LEDGEMENT OF CONDITIONS <br />The undersigned ownevapplicant hereby agrees to hold and <br />save haimless the City of Everett from any and all claims for <br />damages, cosls, expenses, or r.auses of action ihat may arise <br />because of instaltation and maintenance ol t`�e improvement or <br />other iight-o6way use here�o applied foi and further ac�rees to <br />remove same upon notice irom Ihe City and to replace public <br />propert by. <br />SignaWre n� Da�e <br />170HF: AU 1 HOI-liLrD �l' THIi P[Hldl � M11US7' GE S7�R7FD VJ17HIN tti0 DAYS OP DATE PERMIT IS ISSUED AND tHEFEAFiER IS TO BE DILIGENTLV PURSUEU <br />li� COt 1PLFTION I IIIS PFHM1IIT L!AV �E CANCELL�D H1' THF GITV UPON ANV S�OPPAGE OF bN09K ON THIS PROJECT OVER 90 �AVS DURATION. <br />W <br />H <br />i{' ! <br />W <br />� <br />� <br />