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PUBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425( 257-8810 <br />TO <br />320 106TH AVE WE <br />BELLEVUE VA 98004 <br />2062239500 <br />PHONE: <br />DESCRIPTION OF <br />PROPOSED WORK: <br />AND ADDRESS: <br />PHONE: <br />Date <br />Public Works Permit N <br />8u!urng Permit N <br />Planning Reference N <br />Public Works Fee $ <br />Guarantee $ <br />t3 p� 8'3 ?- <br />6/3/2004 <br />PV0406-006 <br />B0401-032 <br />$10,612.75 <br />PERMIT CONDITIONS <br />1. All calls for Inspection shall be made 24 hours in advance - phone (425) 267.8810 <br />2. All work shall be performed In accordance with this permit and current City of Everett D1%sig4 and Cpn�INGiion <br />Standards ^rid Specifications. 1 11 04 1 OF'f9 <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 140-424.5559406006 <br />4. PER APPROVED PLANS DATED 6-3-04 OTHER 862.50 ' gJ <br />PW/RVW 5916.75 <br />PW/INSP 11833.50 <br />TOTAL 18612.75 <br />CAE <br />A ON 881 <br />W <br />1361Ly75 <br />0 <br />Z <br />0 <br />V/ <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless the City of Everett from any and all claims for <br />damages, costs, expenses, or causes of action that may ariso <br />because of Installation and maintenance of the Improvement or <br />other rlght-uf-way use hereto applied for and further agrees to <br />remove me upon Police from ere City end to replace public <br />prop ir Wdamagydyiereby. <br />Sign Darey <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN IBO UAY6 OF DATE PERMIT!STSSUEll AND THEREAFTER IS TO DE DILIGENTLY PURSUED <br />TO COMPLETION. THIS PERMIT MAY DE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />