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PUBLl� WORKS PERMIT Date 1I16I2013 <br /> { <br /> Public Works Permit #: PW1301-009 <br /> City of Everelt Public Works Department 8widinp Permit#; C1301-009 <br /> � �; � 4 3200 Cedar Street <br /> � �" Eveiett, WA 98201 Planninp Reference#: <br /> �4251257-8810 pubiic Warks Fee $. $ 25.00 <br /> Other $ <br /> OWNER NAMF AND ADDRESS: APPLICANT NAME AND ADDRESS: � <br /> ADF.IR EiJTERPRISES LL� <br /> 159'2 El�ST SHORE DR <br /> LYhNWC OD WA 9P087 <br /> PHONE: 42` 7431i18 PHONE� <br /> TAX PARCEI IDM 0055?400600700 SITE ADDf2ES5: 1504 100TH ST SW <br /> DESCRIPTION OF PRO"OSED WORK: <br /> DRIVEWAY FOR NEV�'HGUSF <br /> PERMIT CONDITIONS <br /> 1 All calls for inspection shall be made 24 hours in advance <br /> 2 All work shall be pertormed in accordance with Ihe permit and current C�ty of Everett Design and ConstrucUon Standards <br /> and Specificati�ns. <br /> 3 Call Location L'nderground Service 48 hrs before you dig TOLL FREE NUMBER 611 � <br /> 4 Per approved drainage plan dated 11 8 12 <br /> Your Public Works Inspeclor is CIiH Llndinan Call him al 425-339-7404 for questions and Inspections � <br /> n. <br /> � <br /> O <br /> � <br /> z <br /> 0 <br /> � I <br /> 0 <br /> a <br /> Tp P05TING �!`� ��I� <br /> ACKNOINL[DGEMFNT OF CONDITIONS <br /> The undersic�ned ownedappGcant hereby agrees�o hold and <br /> save harmless t1e City of[verelt'rom any and all claims lor <br /> ---— damages, tosls. erpenses, or causes ol ection�ha�may arise <br /> because o1 mst311ation and mamlenance ol lhe improvement <br /> �- -2��� ' /H . �; or other right�ol-way use herelo apPlied for and furlher a9rees <br /> lo remove seme upon nolice from ihe Cdy and to replace <br /> Approved for Conslruchon Date publ�c property damaged Ihereby <br /> ,/ ? ���^�. _" <br /> ,..�.,.��-��� � J_.��� .-� � . , � ,�- l � �I � , <br /> f ID1lX���N PECTION Dale � - ��``��� <br /> Approved as Conslructed �-�'�/ ' �-3 Signalure ol Applicant Dete <br /> �YUPK AUTIfORIi'(D flV iill5 1'I.kMIT F1U57 BE STARTfD�NRHIN Itl0 DAYS OF LATE PERMR IS ISSUED AND THEREAFTER I510 9E DILIGENTIY <br /> Pi_Iu,�,Ul I� li 1� o1�1P1 I 1104 i HI`, P(RMI1 �4nv !3E U��O I t I U 6Y TIIF CITY UPON�NY S10VPAGE OF YJORN ON THIS PROIEC�OVER 90 DAYS DUfiAT10N- <br />