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PUBL'C' �IrIORK� <br />PI�RMIT <br />PUBLIC'NORKS DEPAPTMENT <br />3200 Cedar Slreet <br />EvereU. WA 9� PQSTI�IG JUN 0 2 <br />(425) 257-BO <br />SLUE FSD�E <br />OWNERNAM¢ 0 gii:C )Oi <br />AND ADDRESS:I�JAI.L <br />U <br />20u8197413 <br />PHONt: <br />I <br />I APPL'CANT NAME <br />RIA �S�1w ANDADORESS: <br />rnace� i.o. a�A -���LISE - SJ1SI�: lb3 <br />DESCRIPTION OF <br />PfiOPOSED WORK: <br />PERMIT CONDITIONS <br />PHONE. <br />PROJECT <br />% ` lOJ5�20G5 •� <br />Daii: % pyU510-006 <br />Public Works Permil q ��0510-QOa <br />8uilding Permit N <br />Planning Reference # <br />625.00 <br />Public Ylorks Fee $ <br />Guarantee $ <br />t. All calls for inspection shall be made 24 hours in advance - pYone (425) 257-8610 <br />2. All work shall be perlormed in accordance with this permit and current Cily o( Everetl Design and Construc�ion <br />Standards and Specifications. <br />3. Call Location Undeiground Service 48 hrs. before you dig. TOIL FREE NUMBE^ 1-800-424-5555 <br />;!. Ctmn&ct 91LIE aew�zc E» r. City Staud�rd M'� o4i, �ii::, fiN9. <br />5. r_.onnect ro��ft��p �r,,u�;;�:.:�uts h� t.he dcainag.� syste+� prc�vi�i±.i foc thi� lot. <br />6. Insta7l rcosion CGlltCfj}, 15G88Ul�ti 3;; det�ewine� by the kuL•1ir ��c}:� inap�to�,�un:js,�;:- <br />as �i2t fenr:e, �traV Ga]ca, S�riles, oc �zcosion k�lank�t5. +'Ri.c.k..r 2_5:3:i9-,2403-}. �� :n' <br />�'�-y�{�yqE F'/1EvlOcfS _�,r/�Er;TlyL � .�1U '.��,:.,.,�..j,: �,��y, -. . <br />� � �0��-7�' _ �, :. `; <br />�vT �9r��E 7� ��� � rPE - . �� <br />y � ��« u,2,�,�,,, - ='- Y �r: <br />, - <br />0�� �� f.��� � L7'S . QC� S/�/o6 �', -� .= <br />J <br />� <br />6i! � ^� �� <br />n_� i�' !if G'� �n Hy -• <br />r f l.I Fr;'/t L�. �4a. YM1 1+^ <br />, �,.� �; :=„_. 4: �2 ;:; c2 i'' c'�.r,-' <br />;+iUl:_;;`�'.,?°'�9�:�s:`=:ri <br />C�0 p� <br />'�Y <br />ACKNOWLEDGEMENT OF CONUITIONS <br />W <br />� <br />�'^ <br />V/ <br />0 <br />� <br />Z <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby ac�rees lo hold and <br />save hannless Ihe Ci: t Everelt Irom any and all claims lor <br />damages, costs, ezpenses, or causes ol action ihat may arise <br />because cf installation and maintenance of Ihe improvemcnt or <br />other righl-of-way use heroto applied for and further agrees to <br />remove s�nfe.Lpon rotice from ihe Ciry and io replace pub:i� <br />property da��iTged t.areby. <br />�y,� • 4... � d/ i/� �C,� ^/ I� i J� <br />Signatu e ol Applican� Dale <br />WOflK AUTHORIZED BY THIS PERMI7 MUST BE STARTEO WIiHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER ISTO BE DILIGENTLY PURSUED <br />TO COMPL.TION. THIS PERMIT MAY BE CANCELLED BY THG CITY UPON ANV STOPPAGE OF WORK ON THIS PROJECT UVER 90 DAYS DURATON. <br />