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Pus��c woRKs <br />PEF�MIT <br />PUDLIC WORrg DEPARTMENT <br />3200 Cedar SImN <br />Everotl, VJA 9B201 <br />,"25,���.�'8 Sil N 6 <br />OWNERNAME <br />�NonooAEss 'J�'AUR.4ttP ��'uR!'�.-�kAT[uN <br />Pi� BUA 13u <br />BELLEVUE WA 9800�'+ <br />� <br />H. NE� q�c�� �b.:'.fljU <br />TR%FARCELID � I)Il'1?�QI)Ill)iJJUllll <br />DESCRIPTIONOF NEW HU['„F - P.Af= jf. .:1515 <br />PROPOSED WORN .. . <br />PERMIT CONDITIONS <br />AUG G 6 r �,,,L <br />PHONE <br />ADDRE55 <br />oem <br />Public Works Permit a <br />Buildmg Pcrmit N <br />Planning Refomnca M <br />PWlic Works Fce S <br />Guaran�on E <br />G3/13/?Ou� <br />PW0203-011 <br />C0�03-013 <br />OItALRANT �'ORFORATION <br />1'u BOX ] 30 <br />5'a'LLEVUE WA 9gp0�j <br />4256262900 <br />:j.:J-Uli <br />I <br />f.,OT 3li �F GuNEt;AL LANE <br />7. All calls lor inspoction shall be made 24 hours in advance • phone (425) 257•8810 <br />2 All work shall bo perlormed in accordance with this permit and currenl City ol Everelt Design and Conslruction <br />Standards and Specificalions. <br />3. Call Location Unde�ground Service 4B hrs. before you dig. TOLL FREE NUMBER 1-800•424-5555 <br />�i.�_��in�..�_t _i�i� ..W..i �..i �.'i! �:�I F•.v.��-it 9: 1, 60.1 6 r,�;q. � <br />� l� Y . ',u��9ni� - �,ii � <br />'� �btui��•t �i�,wn ��uiit^ t�.� Lh� �icainag. y:;t�:rm pruvidNd fut t1ii� lot <br />��. All excavatc-d mat.ei-ia] i�om .UUhCj.1C.1011� 51(jEWd]]C and driveNays _,Loli A <br />bu hauled tn an approv:.�i, pr.cmitte�i sit_�:. No wn.=tinq of material i� V� <br />,�i1CW.-�] �ll� 1��1L ])�l:]t!1L�] ]r�1 . <br />, . 7 <br />pHprovetl lor Conslruttron/ Dale <br />�/� ^� L <br />��'���d�eu�t..� '7�.'z�J -0.2 <br />L NSPECTION <br />/•�rnvad qs ConslmcleA Dole <br />03-20-02 10:18AM <br />N 203012 <br />BUILD 1665.75 <br />SRCHG 4.50 <br />I�CH 80.00 <br />PLU�B 91.00 <br />DRIVE 25.00 <br />b �03053 <br />SEWER 70.00 <br />UTILITY 161�.00 <br />NATER 130.00 <br />TOiAL 3679.25 <br />C HEK 3679.25 <br />A OM7169 <br />ACKNOWIEDGEMENT OF CONDITIONS <br />Tho undersigneW ownorinpplicant hareby agreos to hold ontl <br />seve ha�mlass tho City ol Evarofl Irom any aM all daims lor <br />tlamagos, costs, expenses, or causos ol action Ihal may nnsn <br />becnuse ol installalion flnd mainlnnance ol Ina ImprovemeN or <br />othor rig�ibol-way uso horeto applied lor entl lurt�er eproes lo <br />removo samo upon rrolice Irom Mio City ond to �apWca public <br />d mag t oroby. <br />`�_� �h�l c�— <br />Signaturn �I I ant Date <br />WORK AUTNORIIED UV TNIS P[RI.iIT MU¢T OE STqRIED WITlIIN 180 DAYS OF OQE PEHMIT IS ISSUED AND THEL,?AFTEH IS TO BE DILIOENTLV PURSUFD <br />TO COMPL[iION THIS PERMiT k1AY BE CANCELLED Bv THE CITV UPONANY STOPPAGE OF WOHN ON 7HIS PRQIECT OVER 90 OAVS DURATION <br />