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PUBLIC WORKS Date <br />� (. 16.56 Public Works Permit # <br />PERMIT c3 011.118" <br />IT �•� Building Permit # <br />PUBLIC WORKS DEPARTMENT 3200 Cedar Street Planning Reference # <br />Everett, WA 98201 Public Works Fee $ <br />(425) 257-8810 , $50.013 <br />i 4 550 .a 00 Guarantee $ <br />OWNER NAME APPLICANT NAME <br />AND ADDRESS: DAVI D ANMTF, AND ADDRESS: <br />7 9 31 ` 7ALBO I` RD <br />f <br />EDMONDS 98026 <br />PHONE: 4257752927 PHONE: <br />TAX PARCEL I.D.# PROJECTADDRESS: <br />DESCRIPTION OF <br />PROPOSED WORK: UHORT PLAT I iZO°MV,IRTS 1202-7-05 <br />PERMIT CONDITIONS <br />`t/26/2006 <br />PNO609-025 <br />$50.00 <br />1. All calls for inspection shall be made 24 hours in advance. <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 <br />4. PLR AE'i'P,0 Eft PLANS <br />v <br />A J <br />S <br />d <br />O <br />Approved for Construction Date <br />FINAL INSPECTION <br />Approved as Constructed Date <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant 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 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 from the City and to replace public <br />property damaged thereby. <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 WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />EPWP (7/06) DATABAR, INC. <br />