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1 <br />+. PUBLIC WORKS <br />� <br />PEI�MIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Evercit, WA 98201 <br />(425) 257-OB70 <br />OIVNER NAAfE ��ESON EDWAF?D A�P� <br />ANDADURESS�. AND <br />3414 loTFi ST <br />EVERETT WA gF,"�01 <br />PHONE 9257506118 <br />TA% PARCEL I.D. a <br />DESCRIPTION OF <br />PROPOSED WORK�. <br />PHONE: <br />0�$�b3j?,301:00 I�ROJEC7ADDFESS: 'i91 <br />PLACE d SPREAD 25f1 CY OF FILL DIkT <br />PEHNIT CONDITIONS <br />Dale <br />Public Works Permil N <br />Building Permil q <br />Planning Reference q <br />Public N'oiks Fee 5 <br />Guaran!ee 5 <br />06/30/2003 <br />PW0306-030 <br />1. All calls lor inspection shall be made 24 hours in advance - phone (425) 257-8810 <br />2. All work shdll be pertormed in accordance with Ihis permit and currenl City o( Evere�t Design and Conslruction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBF.R 1-800-424-5555 <br />9. Instsll ecosiun cuntrol a� •�ieectFd Ly the city publi•:r woLl:� inspector. <br />5. };rz�; stceet9 �.'I.N3I1 at a11 times. <br />$93.50 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />V / <br />W <br />O^ <br />+ <br />Z <br />O <br />�'^ <br />V / <br />0 <br />a <br />The undersigned ownerlapplican� hereby agrees to hold and <br />save hnrmless thc City oi Everett Irom any and all claims for <br />damages, costs, expenses, or causes ol action that may arise <br />because of installalion and maintenancr, ol the improvement or <br />olhcr righhot-way usc herero applied lor and further agrees io <br />remave same upon notice Imm tLe City and to replace pubtic <br />property damaged Ihere . <br />Siqnalure�p�� � Dal� <br />WORK AUTH�RIZEU BY THIS PERMIT IAUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREPFTER IS TO BE DILIGENTLV PURSU[D <br />70 CO�APLE7ION tHIS PEFlMIT MAV BE CnNCLLLED BY THE CI7V UPON ANY S70PPAGE OF WORK ON THIS PROJECT OVER 9J DAYS DUFATION. <br />