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Y,,� � <br />i� <br />- -:.t�'1 <br />PUBl.IC WORKS <br />P�F;MiT <br />PUBLIC WORKS DFPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-CH1C <br />AtJD P.DDRESS: � �� � `�r "f i = . . _ . - <br />..i�' �Qj;U.�' <br />_ �-�-: <br />PHONE: ... _ .. .� :�� N'1 f� fj <br />TAX PARCEL I.O.# . <br />.!i'�1: ;,ii'.. <br />DESCFIPTION OF � . <br />PROPOSEO WORK � <br />PERMIT CONDITIONS <br />APPLICANT NAME <br />ANDADDRESS: <br />PHONE: <br />PRQIECTADURESS: <br />Date <br />Public Works Permil # <br />Building Permil # <br />Planning Ralerence Jt <br />Public Works Fee S <br />Guarantee 5 <br />T�� �OSTI NG..�vr�.. �..�--znn� <br />1. All calls for inspeclion shall be mada 24 hours in advance. <br />2. All work shall be performed in accordance with ihis permit and current Ciry of Everett Design and Construciion <br />Slandards and Specificalions. <br />3. Call Location Underground Service M1B hrs. before you dig. 70LL FREE NU�dBER t-800-424•5555 <br />� .e �;i � .�.:nLi �:.. ,'' " .'- .. <br />r Sn, al � '�:�i n .�ni[� . m���utr, �., d�t�:.: � . . ... � . <br />d:� trtlt. '�i•:o� ..tL'3w bal@::� 3wpilp�� nz :.�.._.1�:... �.__ .. . �. . � <br />%. '.�� �:. * fit'1'.j. C� '�:.+ nL �1pt�C1� Y� C�_ tL3�. FF�j nil � L!i�s�'.`r'^��C�cL'i �Ui-,.r'T. --r�' �it� —r_ <br />_. 1i^ },�_Zs�_11�j Tfl5.__L1315 `.! t�:, ::�.ii.�.b.� OTI ..___4r3� . :Ilti{'� �..'.6.�8ii�3 LUY'�'���3'�. i'��_3I' - <br />�,Fu?n inr r,?�9t9:r[ia❑ teacal. �.� ���-;_ '—, �.. <br />, �- C.i <br />.. . .�.�'tT:�C� hF�Y:'C' Y�C�:t ]�' BFJC�Vf' ::l��E`AJ3IIi QL'NCIP. <br />�,�, <br />� � <br />i'� <br />:d .s,� <br />�a <br />. � �, <br />„ �� �� <br />,; «. �,> .. <br />_ _.-.- ..�-� <br />_ ,r.;, <br />— - - ACKNOWLEDGEMENT OF CONDITIONS <br />_� j��.l�� /�/���? The undersiyned own�dapplicanl liu�eby �yreos to hold and <br />��_ c save harmless ihe Cit of Everott irom an and all claims for <br />damayes, cosis, expenses, or causes ol adion that may arise <br />.a�mvo r Constmction / oa because of installalion and mainlenance of Ihe impmvement or <br />,-L�Jr_1c—L�_ "' other nght-of-way use nereto applied for and funher agrees to <br />Ci remove same upon notice Irom the City and to raplace public <br />� FINAL INSPEC N prop�rty da, aged ihereby. <br />I Approved a, nslmclea Dalu � W ,, / v � l <br />1 v�-� / � � l , <br />� <br />�_ __ Signawr Applican va�e <br />':1OFK AUTHORIZED BV 7HI5 PER�d1T �dUST BE S7ARTED WITHIN t6D Dn:'3 OF DATE PGRMIi IS ISSUED AND 7HEFEAFTER IS TO 6E DILI�ENTLY PURSU[D <br />70 COMPLETION. THIS PERMIT IdAY BE CANCELLED BY THE CITV UPON ANY STOPPAGE OF WORK ON 7HI5 PROJECT OVER 90 DAVS DURATICN. <br />I �'l'JP I�/�) OALABA9. INC. <br />/ <br />W <br />� <br />V/ <br />� <br />0 <br />� <br />� <br />O <br />'�A <br />V/ <br />0 <br />a <br />