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PllBLIIC WORKS <br />PE�11�IT <br />PUOLIC WOFKS GEPARTMENT <br />32�0 CedarStreel <br />E,✓ Everetl. WA 9�201 <br />(4251257-�810 <br />OwNEf7 NAME -� "� =�n <br />,vaonooness 94pp 18th Avenue W <br />E`✓ERETT WP. 98�q4 <br />r�iiuNe ']-'53556399 <br />TAxPARCELI.D.tt <br />oEscr���nor� or Fi? 1 in <br />PROPOSfD V:UIiK <br />PEPMIT CONDITIONS <br />;�,otr: in laorn <br />APPLiCANT IJA`AE <br />ANUADDRESS' <br />PHONC <br />Date <br />Public Works Permit H <br />Building Permit q <br />Planning Relerence a <br />Public Works Fce S <br />Guarantcc S <br />rr+o.i�:ci nooaess uq���; 18th rlve W <br />Bi�7i2oD3 / <br />FW0308-0'i7 <br />1. All calls for inspection shal; be made 24 hours in advance - phone (425) 257-8fi IO <br />2. All work shall be performed in accordance with Ihis permit and currenl City ol Fverett Deslqn ;ind Construciion <br />Standards and Specificalions. <br />3. Cali Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />733.OU <br />��. Flll 1� i0 he Fi13�:'B!� 1❑ i!IVWfI 9ia�� axFa� c:nly sn�� 3.�.J71J t�le dJ3ie'CI7R�GY.i iliU� ��I <br />nocth pcoperty linr-_ ,i� pr� y��uc field ronver.:ation� uith Li; �iC�3?I1I13�3en on 6/�r;; r�'. <br />Und�r no cicrumstanoe shall ang fill Y�e placed cic�ser than 75 f�et to any wtlancl. <br />5. ExFused earth �hall br• ce�eeded 3nd ne mulched t,� pcevent Nce:,ion. <br />n. Install ��*hei eer��iun ccmt.ioi m�_asUres ss diceCted hy t.he puLli_: tir,�rk:: insprctc,� <br />the tield. <br />.}'�ap cit.� �t�aer� cl��n at all !imes �l�_uin�i co.�stxur.[i:�n. <br />4 ��4�Lic� 4.� L;.� (xi.��l��.r,�, <br />C���� �� J <br />Appwvetl lor�` onstribon Dal� � � <br />K('_J7" "t I�NLl c.`Z.i� � —� —! <br />Approved as Consimcled Oate <br />:hc <br />in <br />ACKNOWLEDGEMENT OF CONDITIONS <br />WLs <br />r' <br />V+ <br />^W <br />V <br />� <br />Z <br />� <br />h <br />� <br />O <br />� <br />The undersigned owner;applicanl hereby agrees to hold and <br />save harmless the City ol Everelt �rom any and all claims lor <br />damages, costs, ezpenses, or causes ol action ihat may arisc <br />because ol installalion and maintenance ol Ihe improvemeni �r <br />other n Qht-of-way use hereto applied br antl lurther agrees to <br />mmov�sa ie upon otice fmm the Ciry and to replace public <br />proQerty d nage t creby. <br />� / <br />' w�- u�-�' 2 `�j�� 3 <br />Signatu�c IAppl¢an Dale <br />wORK nUTHORI2GD 6Y 7HIS PE(iMIT tJUST BE STARTED WRHIN 100 DAYS OF DATE P[Rh1ii IS ISSUED AND THEREAFTER IS TO BF. DILIGEN7LY PU�SUED <br />TO CO�dPLE�ION. TH13 PGR1dIT MAY DE CANCELLED �Y THE CITY UPON ANY STOPPAGL OP \40RK ON THIS PROJECT OVER S9 DAVS DURATION. <br />