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PUBLIC WORKS PERMIT Date: 10/18/2012 <br /> Public Works Permit#: PW1210-015 <br /> City of Everett P iic Works De�aftx� q t;E;:) 14-. <br /> 3200E pr Street ;,E;;,;r r Building Permit#; <br /> Everett, WA 98201 UlPlanning Reference#: <br /> Public Works Fee $: $ 45.00 <br /> 1 N RE!) x. ' .,J, Other $: <br /> OWNER NAME AND ADDRESS: APPLI T NAME AND ADDRESS: <br /> SAME CHE-i ; ERIC f;$E.SAU <br /> 3815 WOODLAND PARK AVE.N. <br /> SEATTLE WA 98503 <br /> PHONE: PHONE: 2066910476 <br /> TAX PARCEL ID# SITE ADDRESS: 2421 HEWITT AVE. <br /> DESCRIPTION OF PROPOSED WORK: <br /> SOIL BORING <br /> (10/18/2012 10:55 AM BES) <br /> SOIL BORING IN SIDEWALK <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with the permit and current City of Everett Design and Construction Standards <br /> and Specifications. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br /> 4. CONTACT STEVE SAWYER 425-257-7296 PRIOR TO CONSTRUCTION FOR UNDERGROUND UTILITIES <br /> EVEN AFTER YOU DID DIAL DIAL MARK UP. <br /> 5. PUT SIGNS AND CONES AROUND THE BORING AREA. IF YOU NEED TO CLOSE THE SIDEWALK PUT W <br /> SIDEWALK CLOSED SIGNS AT BEGINNING AND END OF THE BLOCK. <br /> O <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 arise <br /> because of installation and maintenance of the improvement <br /> d , or other right-of-way use hereto applied for and further agrees <br /> d for Cons rUC On D to to remove same upon notice from the City and to replace <br /> pprovep blic property damaged thereby. <br /> FINAL INSPECTION Date (v/(7 /z <br /> Approved as Constructed Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br /> PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />