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PIJ�BLlC �IVORKS <br />PERNlIT <br />PUBLIC WOPKS DEPARTIdENT <br />3200 Cedar Sireet <br />� Everell, WA 98201 <br />(425� 257�8810 <br />_�,._ �.._._------- --�- � "��ilN�`", �_�s-D�__ <br />nrioaooaEss.�?':=< =STH A�.'E SE <br />BuTHELL WP. <br />42579;1718 <br />PHON[ <br />l;�x PARCEL I.D. u . _ . . _ . _ .. . <br />7.�.�.' fil�tl::F — <br />DESCRIPTIOIJ OF <br />PROPOSf_� WORK: <br />PERMIT CONDI?IONS <br />APPI.ICANT NAh�E <br />AND ADDfiESS�. <br />SEiii:i <br />PHONG <br />PROJGCI Ai)DRE55.-' � � <br />Date <br />- - . _ , �. <br />_ 'ii=� L=- - <br />Pubtic Works Permit # -�., � i� � : _ . �;,L <br />Buildinn Permit = <br />Planning flefer�ncc n <br />Publi� Werks Fee S °` ' . � � `� <br />Guarantee 5 <br />1. All calls for inspection shali be made 24 heurs in advance - ohona �425) 257-8810 <br />2. All work shall be performed in aceordanr,e wilh �his permi� and :,urrent Ci�y of Everett Design and Construc�ion <br />Standards and Specitications. <br />3. Call Luca�ion Underground Service 48 hrs. be(ore you dig. TOLL FREE NUMBER 1-�00-424-5555 <br />.. r,.��nner_t �id�a s=•.,a�r ���:� �-�r�' �'� ��i�j.3rd:. 6p1,!����:.���'9. <br />. _onnec:t iooi;.:r, .:ie�vr.�p:�ut:. ._ the draina;�� -r�sr._m •�co�a:deo fo� _i�z_ i__. <br />.. Inst:;,ll -[,;;i n ��t[ _ r;..a,u��:� a� �iat�ur,:r.-�1 1.� '.h� F�a:�. �._.-. _.;t,�..r. � .,._.. <br />, .�i?t f �•. . � ,,_- :;,.�- �, �: ; � ;:�ts <br />„ <br />-._ ,'/'� . �:=, .// � �S <br />Apptn ed I r Constmqion ala <br />/J/ � l <br />��c ' -(1�1� . ��/7 i �, �� <br />FINAL INSP TION <br />Appmved a5 Con;Iru^IeA Daic <br />ACKNOWLEDGEMENT OF CONDITIONS <br />� <br />W <br />� <br />� <br />W <br />O <br />� <br />Z <br />O <br />F- <br />� <br />O <br />a <br />The undersigned owneriapplicant hereby a9rees to hold and <br />save tiarmless Ihe Ciry of Everrlt Irom any and all cl2ims for <br />damages, costs, ezpenses, or causes ol action that may arice <br />because of installation and mainlenance c� the improvement or <br />other iight-o6way use hereto applied for and further agrees to <br />remove same upon notice Irom the Ciry ,md to replace public <br />proper�y damaged ihereby. <br />�'� ���iJ1�ul ��� U(o <br />SignaWre�of Applicanl 1 Dale <br />INORK Au7HOHIZED BV TH13 P[R1.7IT f.1US1 �F START[D ;VITHIDI 100 D4V5 OF DA7'E PERRtIT �S ISSUED APlD THEFEAFTEP IS 70 BE DILIGENTLV PURSUED <br />TO COf.1PLET!ON. lHIS P[R1.11T 1.1AY 8[ CANCELL[D BV TH[ CIT1' UPON 411Y STOPPAGE OF WOFK ON THIS PROJECT OVER 50 DAVS OURATION. <br />