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PtJB�IC �IIiORKS <br />PERMIT <br />PU9LIC N,'ORKS DEPARTMENT <br />3200 Ceda� Street <br />F���eu, wn sazo� Y EB 2 � <br />(425) 257�8@1R --- -� <br />^ �: i :'.�� U �--- <br />§ � i .. <br />OVlNERNAGIB c��,-�r_I .,. :EJ S1F� <br />AND A�DRE55: <br />"Ylr4'i A4ti 6[ 1 ST F:T 9:i� <br />L?YE .">:'E�.'ENS "�,h _ _ <br />PHONE�. q�;��'vlin�uj <br />TA%Pnf�CFLI.D.# __��4nt�l(1����)E(�, <br />DE5rf7�Pi�OrJOF - - _ -' . <br />PHOPOS(2U l^JOHK. .•..• .'. ' _ _. _„ ' " <br />PERMIT CONDITIONS <br />APPUCANT IlAI.1[ <br />nNo nour�es> <br />PHO.JE <br />Date <br />Public Works Permit ir <br />Building Permit N <br />Planning Relerence # <br />Putlic Works Fee S <br />Gua�antee 5 <br />P�OJGCTADDRESS . .. .. <br />_ "� 502-'i . . <br />,,,,.;;-,,� <br />-_' .. .., _._5i. :..' _' <br />1. All cails (or inspectiun shall be made 24 hou�s in advance - phore (425) 257-8870 <br />2. All work sh�ll be performed in accordance with lhis permit and current City of Everett Design and Consiruction <br />Standards and Sr,ecifications. <br />3. Call Location Underground Servir,e 4'3 hrs. before you dig. TOLL FREE NUMBER 1-800-4243555 <br />:�rd�.. � _r F _,�.,n �. _ .�w � _h� cit :1i�_a;l- � *�rt. . _ .. _ . _ . <br />. Install Frnsio❑ r�,nte�_�1 m.asue«s as d�r�inir�«.d l:�y tF _ _ � <br />� . �. (:.r._-, . -. . -.� , , ...--. �. .-_.: .,r.'� -.. <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owneuapplicant hereby agrees to hold and <br />save harmiess the Ciry of Everett from any and all claims icr <br />damages, cosis, expenses, or causes of action ihat may arise <br />because of installation and maintenance of the improvement cr <br />olher nght-of-way use hereto applied For and further agrees to <br />remove same on no!ice irom the ity and to replace public <br />property dama d reby� <br />� / <br />_ (j-� - 3 / ' �, d � <br />Signalure oi plic i Date � <br />�v�.�Hb: 4u I r101?I7_ED LlY IHIS PE171:JT I.1UST �E SiaHTCD !;'�fHIN �a0 L�AvS OF �4L'. PGI:F.L1 IS ISSUED AND THEREAFTEf715 TO BE DILIGENTLV PURSUED <br />10 CCI.JF�.E' fIUN. TH15 PERI,IIT I.fAV 6E CANCFLI FD G'i IRL C�i1' Ui=O'J AllA' ciCPPi�GE OP `:JORK ON THIS PROJEGT OVER 90 DAYS DURAi ION. <br />�� <br />