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Date: 3I30/2011 <br /> PV 8�.��i 1 �RKS PERA'lIT public ��orks f'ermit#: PW1103-G19 <br /> Clty nf[verett Public Works Department guildinq Permit #; B1103-038 <br /> ,� �� :_�, . 3200 Cedar Sireel <br /> J ��' Everett, WA 98201 Planninp Re(erence#: <br /> (425) 257-BPto public Wo�ks Fee $' $ 45.00 <br /> Other $: <br /> ,1PPLICANT NAME AND ADDRESS: <br /> UWNER NAME AND ADDRESS: <br /> SWANSON GORDON G 8 �OBERTA l-MOBILE USA <br /> PO �OX 1557 <br /> 10101 DAKO�� VVAY <br /> EVERETT Wq g8104 DOTHELL WA 98041 <br /> PHONE: 206�494279 <br /> PHONE: — <br /> TA% PARC[L ID tt 00552400602500 SITE ADDRESS: 1516 100TH ST SW <br /> UESCRIPTION OF PROPOSED WORK: <br /> [QUIPMENT BLDG-T MO��LE <br /> INCL REPI_ACING PUD POL[ IN ROW ON 1�i0iH ST SW <br /> PERMIT CONDITIONS <br /> 1 All calls for inspecF�on shall be made 24 hcurs in advance. <br /> 2 All work shall te performed in accordance with ihe permit and current City of E:•erett Design and Construclion Standards <br /> ar.d Specifications <br /> 3 Call Location Underground Service 48 hrs before you d�g TOLL FREE NUMBER 871 I <br /> i <br /> 4 Install erosion control measures per City o(Everefl Standards for small parcels ' w <br /> , Ali excavated material (rom toundation, sidewalk and driveways shall be hauled ro an approved, permdted site � <br /> No wasting of matenal is allowed on this building lot � <br /> ('i No dirt, mud, rocks or�ebris to be tracked onto roadway V- <br /> ; Pave driveway irom the iront properly line out to the street paving � <br /> Call f.ldf I indman at 475-339-7404 with yueslions and tor inst,�r,tion O <br /> 0 i\ <br /> � �� ' � <br /> �`- �- ���- � <br /> � �; o <br /> a <br /> ACKNOWL[UGGAIEM OF CONUIlIONS <br /> ihe undersigned ownedappl�canl he�e�y agrees to hold aad <br /> _ ___ _ _ _,____ _ _ snve harmless Ihe Ci�y of Fveretl Irom any and all claims for <br /> I �- - � damages, rosts, expenses,or causes of action Ihat may aiise <br /> becaus�nf installation arld maintenance ol Iha improvement <br /> I ��� or olhgt rigM-o6way u ereto epplied for and further ayrees <br /> C-�� � �db �� c� ___._._._. to re�ove S �e upo�.ice from the Ciry��nd to replace <br /> Approved f Conslruchon Date publ�c a[ap�y dai ag d �ere y <br /> l% <br /> �_ 5 3��c�� <br /> I INAL INSPECTION Date <br /> Approved as Constiucted Sign.ature plicant Date <br /> �;,��RK AUTHORIZ[U BY TN6 PfRMIT I•1U5T BE SfARTED�VRHIN 180 DAYS OF DAT[PE4P71T IS ISSUFD AND THEREAFfER IS TO BE DILIG6NTLY <br /> �+1I!`,�il I� IU CO�•1PI f I I[)N I I�L PI RMIT F1AY f3f CANCf11.CU f1V THE CITY UPON ANY STO?PAGF Of-WORK ON THIS PRO]ECf OVER 9G DAYS DURATION. <br />