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R�< <br />C'_ ; {aT <br />���iC.I6v VIIO��� <br />REF�NI�Y <br />PUOLIC WORKS DEPARTAIENT <br />3200 Cedar Street <br />Everett, WA 96201 <br />(425) 257-8870 <br />----____ ..---- -- — ��--- <br />owr�ea unrne <br />ANDADDflESS: <br />PHONE: <br />TAX PARCEL I.D.N <br />DESCRIPTION OF . . . <br />PROPOSED WORK: - � <br />PERMIT CONDITIOPIS <br />ANDAO�RE55: <br />PHONE: <br />PRQIECTAODRESS: <br />Oale <br />Public Works Permit �� <br />Building Permit k <br />Planning Reference ;: <br />Public Works Fee 5 <br />Guarantee 5 <br />t. All calls for inspection shall be. n;ade 21 huur; in ado��nce. <br />2. All work shall be pei(o�n�ed in accordance wlth this pr,iinit ,ind current City of Evorett Desiyn and Construrl��on <br />Standa:�s and Specifications. <br />3. Call Localion Underground Service 48 hrs. betore yo�� dig. TOLL FREE NUMBER 1-800-424-5555 <br />e <br />�N ��� � ��lt���.. � ..l ' � ; <br />�', sr; �:c' �5 <br />�� <br />w <br />--- �rr . <br />_.1 rv_: -LL <br />��'t �•-+ n � <br />' ;� C::: : <br />'___ _..-_. . __-___ __ ___._. .. ._- .._.._ _ _____� <br />� � / ACKNOWLEDGEMENT OF CONDITION <br />�c'C/- �J� �� // � The undersigned ownedappticant hereby agrees to hold and <br />j� �/T save harmless the Ciry of Everetl from any and all cla�ms Wr <br />I Approced lor Constmction Date damages, cosls, expenses, or causes of action that may arise <br />because of installation and maintenance of Ihe improvement or <br />other right-ohway use hereto applied lor and lunher agrees to <br />I,�-j�� `.` �f-.�-� � _ �- .� remove same upo not:ce irom the City and ro replace public <br />� , FINALINSPECTION _f. � propN:ydyroaged ereby. _ / � <br />,� Approvetl as Con mcled Date !� �"� �f � <br />Q L �i /� •v � <br />__ �� I—G I SignaW�e ol Appiicanl � Date � / <br />;^(iRK AUTHORIZED E3Y 7HI� PGRL'dt tdUST OE STARTFD WITHIN 1B0 DAYS OF DA7E PERMIT �S ISSUE7AND THEREAFTERI$ TO DE DILIGENTLV PURSUGO <br />10 COMPLETIGN. i �uS PEItLtli �AAI' BE CANCELLED BY iHE CITY UPON ANY STOPPAGE OP WOfiK ON THIS FROJECT OVER 90 DAYS �URATION. <br />i.�=���r r�oei onr,�c.�a. rt�c <br />