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, <br /> � <br /> �.1i3l�005 � <br /> PUBLIC WORKS Date <br /> ��os�2-ov6 � <br /> Public Works Permit# <br /> ■ ���'� Building Permit# + <br /> PUBLIC WORKS DEPARTMENT Planning Reference# <br /> 3200 Cedar Street $25,p0 <br /> Everett,WA 98201 Public Works Fee$ <br /> (425)257-8810 <br /> Guarantee$ <br /> OWNER NAME APPLICANT NAME <br /> AND ADDRESS: .L7OC� ENBL�,I�IL3 AVE AND ADDRESS: <br /> EVERETt �f�. ���Q! <br /> 4255"138:cl.� <br /> PHONE: PHONE: <br /> TAX PARCEL I.D.# PROJECT ADDRESS: � <br /> C4NSTkUCT FENf'� �� RIf9HT f��' Y <br /> DESCRIPTION OF <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 /> 4. If the �`st� ev�a:� �ae�i� �.�e €��� t.�sa;� �x��a f�a:� n�a��si�.i�sa��. �3�����;�>;�:�s, �.I�� fen�� ��zst. ��� W <br /> r�utf�ae� a� th� �wt���:'� �x��a��.N. � <br /> �,. �`h� fenre �ha31 n�st �:i�:��� �>* in I��i.�ht � <br /> �'�i y :.. � <br /> .i i-;i <br /> . i ;:.��f <br /> :...._.; �: <br /> ;:::��,.......1t::.7 . . _. ... -., <br /> �, [........ . ........� -��. <br /> . . ;.��.i .....,...i ...:... ,_.. <br /> �.,p„�, ..... � <br /> ,-la' i,��..� O <br /> ;�,f; :i <br /> .,.,.. __ �::,._ � <br /> . "*S. <br /> , . 's:,.=�i � <br /> �'�'' O <br /> ,:;� " .,:.:� � <br /> � ,.. <br /> .._;r,;... , � <br /> _..:a'�:i��'`':.! O <br /> t a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> f The undersigned owner/applicant hereby agrees to hold and <br /> f` �S save harmless the City of Everett from any and all claims for <br /> proved for Construction te 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 applied for and further agrees to <br /> remove same upon otice from i and to replace public <br /> FINAL INSPECTION propeyt�m e er . j <br /> Approved as Constructed Date ,� � <br /> /�; � r _ <br /> Signature of Applica.tit 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 />