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PUBLIC WORi6� IPERMIT <br />City ol Everett Public Works Department <br />3200GtrdarStreet ��,':'� .'Ol�����:1� <br />Evere1G � 98201 ; � �n i <br />(425) :57-8810 <br />`6Mil i�o.�,,;ril" <br />OWNER NAME AND ADDRF.SS: <br />NGUYEN MICHAEL <br />15331 4TH AVE W <br />-- -- • � � <br />rl <br />�i�F'�' <br />LVNNWOOD WA 98087 <br />PHONE: 4257544562 <br />TAX PARCEL ID M <br />DESCRIPTION OF PROPOSED WORI(: <br />iNSTALL STORMPIPF FOR DRIVEWAY ENTRANCES <br />OFF OF 1PTH PN[ W <br />Date. t0/16I2009 <br />Public Works Permit it PW0910-017 <br />1,:,�;; BuildinqPermit#, <br />��il�jnninq Reference #: <br />OWNi6i."` <br />Public Works Fee $: $ 78.75 <br />l iher $: <br />NAMEANOADORESS: <br />P�iONE: <br />SITE ADORESS: 1915 98TH PL SW (8 1919) <br />PERMIT CONDITIONS <br />1 All calls for inspect�on shall be made 24 hours m advar�e <br />2 All work shall be per�orr+�=d m accordance wdh th � permit and currenl Ciry ol Everett Design and Construction Slandards <br />ani Specilications <br />3 Call Location Unde�ground Service 4b hrs Lefore you dig TOLL FRF.E NUMBER 811 � <br />4 Shallow sump al culvert inlet, 4" - 6" quary spall armor over and around mlet and an ahiminum tresh rack or <br />equal <br />Call Clifl Lindman. 475-339-7A04, for inspect�on <br />`.�' ���%.=;�.��-:�u�--- /U-27-U9 <br />Approved for ConstrucUon Uate <br />. i � .. .-� /� - <br />, �. - /. ..- --- �-<• <br />�i INSPECTION Date <br />Approved as Constructed ti�-�': '� - '�' ���>%; i' <br />ii' <br />ACKNOWLEDGEM[NT Of CGNDIIIONS <br />T he und��rsigned ownedapphcant I.c�eby agrees lo hold and <br />save haimless the City of Evere�t Srom any and all claims lor <br />d�mages, cosls, expenses, or causes of aciwn thet may erise <br />because ol inslallation and mamlenance ol lhe unprovement <br />or olher nghbo6w���111''' use herelo appGed for and luriher agrees <br />�o�emove s�e u�i notice Irom the City and to replace <br />public prope y da ged ihereby <br />`'�� Signature of AppOcant <br />Date <br />/�Nsf�; . �- f'Q ��(• _ <br />WORK AUTHORIIFD 81 THIS PFHMIT MUST 6C STARTED WITHIN I80 DAYS OF DATE PCR�71T IS ISSUED AND THEREAFTER IS TO BE DILIGENTIY <br />PUHSUFD 10 C01dP1 ff ION IHIS Pf�NI•!Il D1Av 8[ UNCEILED BY TfIE CITY UPON ANV S10�PAGE Of WORK ON THIS PROIE("T OVER 9U DAVS OURATION. <br />