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PUBLIC WORKS PERMIT Date: 4/16/2009 <br /> � <br /> � Public Works Permit#: PW0904-027 <br /> City of Everelt Public Works Department guildinp Pe�mit #; <br /> �j a 3200 Cedar Slreet <br /> �;`f`��� Everett, WA 98201 Planninq Reference #: <br /> (425) 257-4810 public bVorks Fee $: $ 35.00 <br /> Other �: <br /> OWNER NAME AND ADDRESS: APPLICAN7 NAME AND ADDRF.SS: <br /> BUSCH EOWARD JOHN SAM PARK, ARCHITECT <br /> 1016 9TH ST <br /> ANACORTES WA 98221 <br /> PHONE: 2066248498 <br /> PHONE: <br /> TAX PARCEL ID# 28D41300100100 SITE ADDRESS: 8500 E`/ERGREEN WAY <br /> DESCRIPTION OF PROPOScD WORK: <br /> PAVING FOR PARKING FOR BANK OF AMERICA <br /> PERMIT CONDfiIONS <br /> 1 All calls for inspection shall be made 24 hours in advance <br /> 2 All work shall be pertormed in accordance with the perm't and current C�ty oi Everett Des�_�;� ar,:i Ccr„rucLon Standards <br /> and Specificalions. <br /> 3 Call Location Underground Service 48 hrs be(ore you dig. TOLL FREE NUMBER 811 <br /> 4 per approved plan <br /> L:a <br /> �.. <br /> ... <br /> V) <br /> � <br /> 0 <br /> 7 <br /> � <br /> � <br /> � <br /> `� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> Thc undersigned owner/applicanl 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 instal!ation and maintenance o(the improvement <br /> _ I— l— ,.,O. or other right-oFway use hereto applied(or and further agrecs <br /> ���'-� ��/ to remove same upon notice from the City and to replace <br /> Approved fOr Cons uction Date � public property damaged Ihereby. <br /> ���i''�'�����_- - � '' `� �/�- l� �� <br /> FI �t SPECTION Date � � ��� <br /> Approved as COnstruCtEd l' �� " Signature of Applicanl Dale <br /> VlORK AUTHORIZED BV THIS PERt4Cf F1UST 8[STARTED 1YITHIN 180 DAVS OF DATE PERMR IS iSSUED AND THEREAFfER IS TO BE DIL1GEfJTLY <br /> PURSUED TO CO'�iFLETI0t1 THIS P[R�41T FtAY [tE CAt;CE:LED�V Th�E CITY UPOt!h�JY STOPPAGE OF�YORK ON THIS PROJECT OVER 90 DPYS DURATION. <br />