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����'� �O��� Date <br /> �r�4/2E�Q6 <br /> Public Works Permit# <br /> PERMIT �'�°�°`�-��� <br /> Building Permit# <br /> PUBLIC WORKS DEPARTMENT Planning Reference# <br /> 3200 Cedar Street <br /> Everett,WA 98201 Public Works Fee$ <br /> (425)257-8810 $1,��j.��} <br /> Guarantee$ <br /> OWNER NAME � �A,d�,L�'i�' ,I,j,C", APPLICANT NAME <br /> AND ADDRESS����_��� ��z� �4� AND ADDRESS: <br /> �'�' '�`�"�° �t�. �$:�F��. <br /> PHONE: ������`���'s�:i PHONE: <br /> TAX PARCEL I.D.# PROJECT ADDRESS: <br /> � � � <br /> DESCRIPTIONOF �F.�DEF F�j,j,� �t�,�`,�f�� ;�i���+�-.�� <br /> PROPOSED WORK: <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance- phone (425) 257-8810 <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs.before you dig. TOLL FREE NUMBER 1-800-424-5555 <br /> �. PEk �FPRt.�'�IEIk Z��I� ��sTEL� '�—:��—t3� � <br /> � <br /> _ ._ � <br /> V♦ <br /> � <br /> O <br /> . � <br /> , Z <br /> O <br /> � <br /> � <br /> O <br /> - a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � <br /> The undersigned owner/applicant hereby agrees to hold and <br /> � �,� save harmless the City of Everett from any and all claims for <br /> Approved for Constru � Date damages,costs,expenses,or causes of action that may arise <br /> because of installation and maintenance of the improvement or <br /> other right-of-way use hereto appiied for er agrees to <br /> ` remove same upon notic ity to replace public <br /> FINAL INSPECTION property da ereby. <br /> Approved as Constructed Date <br /> r''"".��' � �� d� <br /> 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 PURSUED <br /> TO COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />