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� . • '. <br />, . <br />� � <br />� <br />PUPLIC WORKS DEPARTMENT <br />3200 Ced�r Streel <br />Evcrett, WA 98201 <br />(425) 257-8810 <br />OtvNERNnME La�lr.e ti�[V:}' �1�LW7K1 <br />ANDADDf�ESS�, 1���75 AiL'�n7CC W3y <br />S NOHCY�L.T SH 47.A <br />PHONr-: "36D5689801 <br />7nXPARCELLO.G <br />D[SCRIPTION OF <br />Pf70POSED WORK� <br />PERMIT CONDITIONS <br />taC <br />aa�op I <br />PHONE: <br />PROJ[CTADDRESS' <br />1❑ EX1.ZIlJLillr. <br />Date <br />Public WorY.s Pcrmil u <br />Building Perm�l a <br />Planning Reference q <br />Fublic Works Fec S <br />Guatanfec S <br />1 u 1•:; _ �! G �l <br />PCiU41�-i�i�a <br />�` <br />: '��� j^-'. <br />1. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br />2. All wo;k shall be pertormed in accordance w�th ihis permi� and current City of Everell Design and Construction <br />Standards anu Speci(ications. <br />3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800-424•5555 <br />�. 7.� pec apProved plan dated 12-15-Q4 and the public w�ck:; in:�pector� dicect.-on in <br />+:I��> ti�l�:i. <br />.. Feep �:ity streets clean at all t.imes during ��anstiuction. <br />6. Provide ecosioa �_onteul a� dicected by the puhlic weks in�pertoc. <br />7. Ail vock shall confoem to th�� �ity of Ev�eett Stenr�Aeda vnd ;De<lfica*_ion_� f:•� <br />p:.Y�l�.��.i,i��i�t . <br />(�i�� �.. l2 � I �-04- <br />Approved lor Constmclion Date ,7 <br />��i <br />�l��i���_..-�2`� — <br />. L INSPECTION � <br />ApprovedasConSimcled Date J `�'ti��� <br />_ � ��; <br />j���-.>7f /iz:l,.,iii✓r <br />!.:'-16-04 L:3';: <br />![ 04i�0��� <br />';l/KUW 4E6.�= <br />U/7.NSP S'7".SO <br />'.7i=" .._'_I <br />,;' ..;;F' -0.0�� <br />,-Ji?,'_ 1+59,:_ <br />; �2'�i '=-. <br />ACKNOWLEDGEMENT Or CONDITIONS <br />The undersigned ownedapplicant h�reby agrees to hold and <br />cave harmless !he Ciry of Evemtt hom any an; all claiins lor <br />'� damages, co:.ts, expenses, or causes of action that may arisc <br />` because of installation and maintenance of ihe improvement or <br />othcr right-obwa� use hereto applied for and furiher ay�ec� to <br />remove same uppn,ry�tice fmm the Ciry and to replace public <br />property damagp}i(hj�reby. f , � <br />SignaNre <br />�•;061K nUi 110RIZ[U 0'! 1: uS P[��^I7 L1UST BC S7nRT[D N,'ITHIN 1B0 DAYS OF DA7E PERMIT IS ISSUED AN�7�E�FTFF IS TO BE DILIGENTLY PUFSUED <br />TO CO`.'.PL[TIOi: THIS PCH1.9i ".1A\' OF G11�lCGLI Ff) PN THG CITY UPON ANV STOPPAGE OF W7RK ON THI P J[CT OVEF 9U DAYS DURATION. <br />