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PUBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA gB207 <br />(425) 257•8870 <br />OWNER NAME ShIITH R M/ SMIT$ R B / SMITH <br />ANDADORESS: <br />izs2 aucxm Avs <br />EVEREI'P i1A 98201 <br />PnONE: <br />TAXPARCELI.D.M 28091300302700 <br />DESCRIPTION OF ,��C� pO� <br />PROPOSED WOFK: <br />PERMIT CONDITIONS <br />PHONE: <br />PROJECT <br />Date <br />Public Works Permit k <br />Building Permit N <br />Planning Relerence H <br />Public Works Fee S <br />Guarentee $ <br />SPRINf pC5 <br />9256708651 <br />l,�lb/2009 <br />PQ0901-011 <br />80901-019 <br />1. All calis 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 Ciry ot Everelt Design and Construclion <br />Stanrlards and Specifications. <br />3. Call Localion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-8Q0-424-5555 <br />590.00 <br />9. Provide aediment inaerGs in exisitng catch baain�. Provide additional erwion <br />contcol at the direction of the public vorks inapectoc. <br />5. No tracking of sud 6 dirt onto the public right-of-vay. <br />6. Call 425-339-7903 for public rrorka inapectiona. <br />Z � G "(�t- <br />Date <br />FINAL INSPECTION <br />Approvetl as Construcied �ate <br />C=-=.i-�14 <br />� <br />"eUi.! n <br />SFCNG <br />31 <br />OTN_^n <br />F d/4V�; <br />°'Ai 7:NS"r <br />TOTAL <br />�:41F,� <br />4"vli)_9 <br />748. i;, <br />4,SC <br />:.pip�_ <br />5li.3: �/�1 <br />20,JU <br />20, vfi <br />343.z5 <br />k.-.. t-.i`",-:. <br />a �)M�E'��5 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless ihe City of Everetl from any and all claims for <br />damages, costs, expenses, or causes of action that may arise <br />hecause of inslallation and maintenance ot the improvement or <br />other right•ot•way use hereto applied for and further agrees to <br />remove same upon notice from Ihe City and to replace public <br />prop e by. <br />L�/�Zc-� Z Z Q <br />SignawreolApp-ant Data <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PEFiM1T IS ISSUED AND Tl1EREAFTER IS TO BE DILIGENTLY PURSUED <br />TO C01.1PLE710N. THIS PERMIT MAV BE CANCELLED 9Y THE CITV UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS OURATION. <br />