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PUBLi� WORKS Date ?, 15/200�
<br /> Public Works Permit# �� ��'
<br /> PE R M 1 T = : : Building Permit# y
<br /> PUBLIC WORKS DEPARTME[�lT-� :=_-,_,�-,. Planning Reference#
<br /> ,,, ._.. = :_��.. :
<br /> 3200 Cedar Street " "
<br /> Everett, WA 98201 Public Works Fee$ Y v-
<br /> (425)257-8810 _ - .
<br /> = Guarantee$
<br /> OWNERNAME :��0 L. SCLli,il.Y.y APPLICANTNAME
<br /> AND ADDRESS: ��p��, ���.�t �s`� AND ADDRESS:
<br /> EvcrFtt �A `_'i?�._ _ _
<br /> �jr:'��.:�.r,l�
<br /> PHONE: PHONE:
<br /> TAX PARCEL I.D.# PROJECTADDRESS: _ ; ` �;r..,� �.,...
<br /> ,_ "
<br /> DESCRIPTIONOF �' ' "J'
<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
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<br /> 5. Ne� clrive�a3,r shall be �iiErCr:� �,rith a� h�rd sur#a�.:in,:{, V♦
<br /> 5. The n�sa driyYway ap�:}roac�l :�i�,s3.1 E�a� a:� pec ��it�= r�f rS�+�c�tt .�t:3fl�j3L'tj �lan �"?i;�= .
<br /> with tit-� � ? . - ; �r t-,� t� �;,: ::�- v,,�n s ful� >�-��:t�; ��cx�an i�: r �
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<br /> ACKNOWLEDGEMENT OF CONDITIONS
<br /> C��� p � '� The undersigned owner/applicant hereby agrees to hold and
<br /> �C.J�.� save harmless the City of Everett from any and all claims for
<br /> Approved for Construc on D e 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 notice frocn the City and to replace publ
<br /> FINAL INSPECTION propert 6amaged�ereby. ,
<br /> Approved as Constructed Date ;
<br /> �,,� � ���� .�'�.S
<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 WOFiK ON THIS PROJECT OVER 90 DAYS DURATION.
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