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- <br /> PIJBLIC WORK� °i1e =; �;-, �"� <br /> PublicWorkSPe�m�.�: "i'��60��-,��.!- <br /> PE R M 1 T Buiiding Permit: <br /> FUBI.IC VlOHKS DEPARTMLNT Plannin9 Relerence= <br /> 3200 Cedar Street - , :j,j <br /> Everetl.WA 58201 Public Works Fee> � "�� <br /> EV �a2e�zs�-eeio <br /> Guarantee s <br /> OVJNEflNAM[ C111CJU ai W1Cele�� l.PPLICANTNAASE 4�I - 6i�U�J KUfZUCS <br /> FNDA�DRESS: SbZZl }!E 72nd Wiy �NDADDRE55�. r��r� T�pr�p��cC FaL'�1; W25t <br /> R�DMONU WF. 98D5= Tukuila �P. 991Et� <br /> PHONE: PHONE SOS7"157�Q� <br /> TAX PARCEL I.G.tt PROJECT A�DFESS:- �_� �,� _, �„'� ',-_ : <br /> DESCHIPTIOi`OF 171�aLLidL' COli�N�lIl1C3C1G11 ��/3LL t 1❑ Ff.�i: � <br />� PROPOSEOWORK: ?G'ZO L/l. �f"S. l�L� . <br /> PERMIT CONDITIONS <br /> 1. All calls(or 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 Everelt Design and Construction <br /> Standards and Specifications. <br /> 3. Call Location Underground Servico 48 hrs.be(ore you dig. TOLL FREE NUMBER 1-800•424-5555 <br /> 9. As per approved plan datFd �,/:/4r; am:l th� put�lic wocks in�n-rc:toi '� di[ection in the � <br /> field. <br /> 5. 4'his F�rrn:it to locate gec�und t�a�eci cellulae equipme.nt. in a vault in the k/G is ��/� <br /> is�ued ��ecsuant to thz extenusting cierumstances rceatvd by the widening of SF-529 and V� <br /> doFs not uonstitute a chan,�e of the City's policy to have the gcotmd b2setl poetipn t�f M <br /> cellulai in.^,rallati��ns lecate en peivate peopecty when using existing utilitv pole, as LY <br /> nntenna �ite�s . Q <br /> � <br /> -.� ,� Z <br /> ( i" rv� �� � x ') ; 6 G i/1 � <br /> w(%r l� �U � �� Y1,UT I�l� � <br /> � <br /> i.���v�,l C�� � �i � � � m,l � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> �__/`.// �eiP „ � /O / Tho undersigned ownedapplicant he:eby agrees to hold antl <br /> ���,�yf� bj7,�p�,y .3 �o save harmless the City ol Eve�ett from any and all claims tor <br /> rovod br Construction atn damages,wsts,expenses,or causes ol ac�ioe Ihat may arise <br /> becauso of installation and mainten:,nce of ihe improvement or <br /> olher righFof-way uso hereto applif ;lor and further agrees to <br /> remove same upon notice Irom ihe Ciry and lo repiace pu�.�c <br /> FINAL INSPECTION properry tlamaged thereby. <br /> Appmvetl as Conslmcled Date <br /> Signaiuru oi Appl�can� Date � <br /> PJORK AUTHCFIZ[D�Y THIS PLFlIAiT 1,!UST�E ETAHTED ClITHItJ 100 GAYS OF CATE PERI.IIT IS ISSUED AND THEf7EAFTEH IS TO�E DILIGENILY PUFSUGD <br /> i 0 COL:PLcTION.THIS P[R1dIT IdAV�E CANCELLED 6V THG CITV UPCN AI:V STOPPAGE OF l'CJ�K ON THIS PROJECT OVER 90�AYS DUHATIO'J. <br /> � <br />