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PUBLIC WORKS <br />PERMIi <br />PU�UC WOPKS C�PARTMENT <br />3200 Cedar Slrc�; <br />Everett,WA9B201 ;�, .,. ,; ., 7.0�L <br />(425) 257-8810 . ... . . � ^ ; ,- .. <br />;,� __ <br />/ <br />Date q��1/,SOU.; <br />Pu6licWorksPermitq r,(yp�pq-�iij� <br />Building Permil fi <br />Plannin� Relerence a <br />Public SYorks Fce 5 <br />��T�N'i • <br />P•U�04-iif�! <br />DWNERNAMEDFIAYCiF_ i.ilivG DUGI',� �PF'LICANTNAME �, T <br />ANDA�DRESS. ANDADDRESS: BOTr.SCH IJA..,H Fi HAL`. <br />7�00 F.VEPGREEN WAY Zy15 HEWITT AVE <br />EVEFE'iT S9A �S::03 EVEFETT F7A ��3�01. <br />PHONE: 4�[� ��_7SfOjO PHON[: �a��_r-�,-;59086^0 � <br />TAY.PARCELI.D.k <br />0033G5U70fC?pq <br />DESCRI?TION OF <br />PaoroseowoaK:�3EW :;EI�VICE BUIL,DlId, <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be rnzde 24 hours in advance - phone (425) 257-8810 <br />2. All worl: shall be performed ir� accordance wilh this permil and current City of Everett Design and Conslruction <br />Slandards and 6pecificationa. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424•5�55 <br />d. A_ p��.. aZp;�rGv,=d :1,111 i.9._it�i�: r,j.:-/0.: <br />U:,-30-0� <br />1! <br />EUILD <br />F'lAN Ct; <br />SFCHu <br />ii <br />SEWE3 <br />�� <br />vwih�w <br />PW/TNSF' <br />� <br />OTHEF <br />Vai6� <br />OTHcR <br />OTHc^n <br />N oi a� <br />3: J'7Fhf <br />0�0400]. <br />1665.75 <br />1�3.76 <br />4.50 <br />0�05030 <br />30.U0 <br />o�oaoo� <br />^io. o0 <br />�t20, 00 <br />177317. <br />490.U0 <br />*90.00 <br />9900�00 <br />1�354.01 <br />A ON81�4 <br />`yb.Sl.l. U',J <br />qGe� —' <br />Z <br />� <br />'�^ <br />v� <br />� <br />a <br />C HE 1^c354.01 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agmes to hold and <br />save harmless the City of Everett from any and all clair is br <br />damages, cosls, expenses, or causes ol action that may arise <br />6ecause ol installation and maiNenance ol the improvement or <br />other right-o4way use hereto applied for and funher agrees lo <br />remove same upon notico irom the Cily and lo replace public <br />prope amaged ther <br />�D V� <br />naiureotApplicant Date <br />WORK AUTHORIZE� BY THIS PERMIT MUST 9E STARTED WITHIN 1B0 DAYS OF DATE PEfiMIT IS ISSJF.D AND THEREAFfER IS TO BE OILIGENTLS' PURSUED <br />TO COMPLETION, THIS PGRMITMAY BE CANCELLE� BY THE CITY UPON ANY �TOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURAfION. <br />