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PUB�ic wIDRKS <br />PERMI'T <br />PUBLIC WORKS DEPARTI�ENT <br />3200 Codar Slroet <br />Evaretl, WA9B201 ,JUL 1 2 2002 <br />(425) 25�.�,oPOSTI N G _-- <br />IWNERNAMH.iELLERSON CONSTNUCTION APP��CANTNAME <br />N�RLDRESSj�OH 48TH ST $W ANDAD�RESS. <br />EVERETT WA 9R'OJ <br />PHONE. ( 47.G )252-6704 <br />TAx PARCEL I D. / <br />OESCRIPTIONOF NEW HOUSE - bASIC �l 77 <br />PROPOSED WORK <br />FW <br />PERMIT CONDITIONS <br />PHONE <br />Dato 1?,/07/1001 <br />Public Works P�rmil M PW0112-011 <br />Building Pormil M <br />Planning Rofemnca 1 <br />Public Works Fao S <br />Gumantee S <br />�i:10 !15TH P <br />C0112-005 <br />f>i5.00 <br />LOT 5 <br />1. All calls (or Inspection shall be made 24 hours in advance - phone (425) 257-8810 <br />2. All work shall be peAormed in accordance with Ihis permit and current Ci�y oi Everett Design and Canst�uction <br />Slandards and Specilicalions. <br />3. Call Locetion Undergruund Service 4B hrs. belore you dig. TOLL FREE NUMBER 1•B00•424•5555 <br />4. Cot�tact tlie Mul:i ] t.eo Wat��t Li,;t i i��t (,..I � z�iiriect iny provisic�us <br />�h:d })Uitrjitlq'r w.➢r.4.r di�iCi SnW.•t :;�ttvi.irwr;. <br />�. Conn�rt � c,o1 l o�, duwi����,-,uL� t�� t Lo di a' n��ye :_;yst em ��i nvi��d fo� <br />Ic�t, <br />��,.;� � � � o� <br />-Appmvnd lor Construc�ron Da e <br />�,kc� /��-- 3 —z� —d� <br />FINAL I— NSPEC�TI a <br />a��ovna as co�si�uc�ea oeie <br />foi <br />tliis <br />W` <br />r <br />'�A <br />V/ <br />W <br />O <br />� <br />Z <br />O <br />� <br />� <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Tha undarsignetl ownor/appGcent hereby egrees to hold erW <br />snve harmloss Mo Ciry ol Everolt from eny entl ell clalms lor <br />dnmagos, cosis, evpenses, or causes ol aclion ihat may arise <br />becauso ol installation and maintenance ol the Imprwomont or <br />olher right-ol�way use herelo applietl lor and IuMer egrees to <br />removo same upon notice Iran the Cip• end to replace public <br />�'�pi rty dam god Ihe by. <br />-��=�'Q�- <br />Spnelure o111ppIKen1 Dale <br />WOPK �UTHOPIZED OY THIS PERMIT MU57 BE STARTED WITHIN 180 OAYS Of DATE PERMIT IS ISSUED ANO THEFEAFTER IS TO BE DILIOENRV PURSUED <br />TO COttPI[710N 7HI5 PEHNIT MAY BE CANCELLEU BV TME CITY UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVER BO DAYS DUNA710N. <br />