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PUBLIC WORK� <br />PERMIT <br />PUBI_IC WORKS DEPARTA4ENT <br />3200 Cedai Street <br />Everett. WA 98201 <br />---- _ ��z5,z��'�Q�TING _.�u �� 6 20�6 <br />r.ver�ea Nnn+e 170:2 :5TH hVi: :iE <br />41JD n�DFESS <br />�.i:TfiELL 4p. <br />�::574: 1718 <br />PNOtJE: <br />-�on.. -�.r�. <br />T��PARCE�yt1�i.;�, it*�'— <br />PtEF� Hi:r�:;E - EASii <br />D[SCflIPTION OF <br />PROPOSEDINORH. <br />PERMIT CONDITIONS <br />Uate <br />�_� ;:, .:��, <br />Public Works Pcrmit � -�' "" 11 -. i-i <br />C�.��. �.. i .. . . <br />Ouil�ing Permit a <br />Plan��ing Heference # <br />Public Works Fee S - � � • ��'�' <br />Guarantee S <br />- APPLICANT NAME <br />AND ADDRESS: <br />iFf�1_ <br />PHON[: <br />PROJ[C7 ADDRESS::; '" � i " ' • � .. — <br />7:, <br />.. .......: . . . ..�-_---�—• <br />1. All calls for inspedion sliall be made 24 hours in �dvance - phone (425) 257-8870 <br />2. All work shall be performed in accordance with this permit and current Ciry of Everett Design and Construaion <br />Standards and Specificalions. <br />3. Call Location Underground Service 48 hrs. 6efore you dig. TOLL FREE NUMBER 1-800-424-5555 <br />�]. ��ppp..�:Y :1��� 3�:.�<,C �iFC t71`i iC3I1��.iC��: r,i�'I � nli��„�i�i:}. <br />�i. ('GI1T�:'i _>pfT.�.l�� C�6WT13F�OUtS 2�� f.Il�i !"�L:i1f1aC:_ ' ;T-_•I➢ '�C�:V1:1i'•-I _;'C i�Ild i <br />Y.. ZII:`.31i '=L.SlI .��� t 1 � 1 •• <br />il ..77_C I�-�.,1 �- ::�- YI�-I�b� I.} =IU- _.:..7.:1: LIOCKJ' II1S�:��.:liL :�.�. <br />r� <br />.�� .._ . . ❑_'P� L(... �:i_ , ,,..,._ � __ i.._ �... !"i��"_,. <br />ACKNOWLEDGEMENT OF CONDITIONS <br />/I <br />� <br />Y / <br />W <br />O <br />� <br />O <br />Y / <br />O <br />a <br />The undersigned owne�/appiicant hereby agrees �o hold and <br />save harmless �he Ci�y ol Everet� Irom any and all claims br <br />damages, cosls, espenses, or causes of action that may arise <br />because of ins�allation and main�enance of Ihe improvement or <br />other right-of-way use hereto applied for and further agrees to <br />remove same upon notice Irom ihe City and to replace public <br />pwpP`y dama erehy. -I <br />Sign�'�-� 1 �.-� 1 � b � <br />bfApplicant Datc <br />CJORK n11THpRIZ[D GV THIS PERtdIT M11U57 E3E STARTED WITHItJ t80 DA1 S Of DATE PER1dIT IS ISSUED AND THEREAFTER IS 70 8E DILIGENTLY PUFSIJED <br />i0 COIJPL[ i10N. THIS PGRM1IIT 1.1Av B� CAP:CELLFU BY THE CITv UPON AIJ1' S70PFAGF. OF lM1'ORK ON THIS PROJECT OVER 90 D4Y� DUHATION. <br />