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_ Date '.� E,'_U':�'i <br /> ����'� ��e '�� PublicWorksPermitk F��8�5-�'''- / <br /> PER1�lIT auildingPermit;t ��?�' `'-i�`' <br /> PUBLIC VJOflKS DEPAR�i MENT Planning Relerence k <br /> 3200 Cedar Street <br /> Everett,WA 98201 Public Works Fee S l;:I°.,!�0 <br /> (425)257-8810 <br /> GuaranteeS d� ���� ` <br /> aS 1�.,,_-, <br /> OWNEN.'+A�dE � � APPLICANTNAME � <br /> �ANOPODRESS: '-� j;,;: c' � � ANDADDRE55: <br /> � rl:i I.J%. : <br /> , :29 16T?a ST <br /> �'IEFLTT G'7ti 9�=G1 <br /> PHONE: PHONE: . .� Y I <br /> I <br /> TAXPARCELI.D.N PROJECTADOPESS: � <br /> � <br /> DESCRIPTION OP ,L � <br /> PROPOSEDWORK: PLA�.'P !Ai,r�11Lk`t. :r.7:T�'_ �iiT?,jj!;;: �"L�rLT?. �irT'.i�1 , � S�u Si <br /> - - 3`t�.� <br /> -- _ _ _ _ � <br /> PERMIT CONDITIONS <br /> 1. All calls�or inspectlon shall b� made 24 hours in advance <br /> ?. All work shall be perto�med in�cr,ordance wilh this permit and current City ol Everett Design and Construdio�� <br /> �tandards and Specifications. � <br /> 3. Call Localion Underqround Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800-424-5555 <br /> _ . .. : ..._�i•_ . >t _ . . . _�ri«�� ; ��. . . _, ..��i_, . .. .. _ [.,i,�'- - - __ . . -. :_ . � <br /> � <br /> . .p;:nf•^_t �tlt �q..�{tJ�'�rjO�::7SF�OtItS t0 *_}7B �� .1_��„_.._L . ..•. . 1 (^ <br /> 'iie cvrtrartot mu,t roeet wirh the Put;lic t�ork, In,�ertoc to �j19rU9"r.` potential v���w <br /> .LOdS�r� I rnl[10(� �n�:LOr tr� }�c.C�lf7f1371!t t�lr. ��CnioCf . :-' ' .' - _'. — �.. . ■� S <br /> t��[RO;rc QCn910l1 COIli'�nl IIl�d9i3L�]9 4O•7❑ pn�prlr_tlr.�❑ pf th (]L�?]w £:F�£20l:n ,�'ST�1�1:�:! i� <br /> oval =,f ±ne peemiL - _- `-'�`-' � <br /> - •; - <br /> _ , <br /> .-. - . _ .._,. , . . ._ <br /> . <br /> , . . .. <br /> , -- - . <br /> , . . , _ <br /> _ � <br /> r-; Z <br /> � O <br /> � �r � <br /> � :.�<r.cry�r. cn r�-� � <br /> lJt.]C Ll%=aK.•=•.L�1 <br /> �',.�n��:1 Ce(n O�:'.]� <br /> .. � � . , � . .�'i[ . ..` � <br /> i I.. _ � <br />' . _. _ . .__. . — _ ____ _ . _. ..__ .___ ._ " _ _... _____.. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> i The undersigned ownedapplicanl hereby agrees to hold and <br /> � � I��` F �/ b � save harmless Ihe Cily of EvereU Irom ary and all daims lor <br /> J damages,cos�s,expenses,or causes of ac�ion thal may arise <br /> rov r Cor�truceon f� , oa because of installation and mainlenance ol Ihe improvement or <br /> ; � I // <br /> � other�ioh4of-way use hereto applied for and fuhher agrees to <br /> � ` � . <br /> � , �����/ _'_���� remeve same upon notice from the City and lo replace public <br /> FINAL NSPEC71 property ed ihereby. <br /> Approved as � !mctetl Dnte , � <br /> 5�2.i/o`c <br /> ___ SignaNre ol pplicanl ite <br /> bvORK AUiHORIZED BY 7HIS PERMIT 61U5T BE STARTED'NITHIN 180 OAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSU[D <br /> 70 COMPLETION.THIS PERMIT MAY BE CANCELLE�BY 7HE CITY UPON ANY STOPPAGE OP WORK ON 7HI5 PROIECT OVER 90 DAYS DURATION. <br /> [_rWp Oro61 o�rnoaa.iNc <br />