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PUBLIC WORKS <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />Date <br />10/10/ 2007 <br />Public Works Permit# <br />PF10710-009 <br />Building Permit # <br />Planning Reference # <br />Public Works Fee $ <br />r25.00 <br />Guarantee $ <br />OWNER NAME APPLICANT NAME <br />AND ADDRESS: Glen Morgan AND ADDRESS: <br />11217 3 � Saute <br />�f:h dr. S.�,s <br />Everett Zia 98208 <br />PHONE: 4253444972 PHONE: <br />TAX PARCEL I.D.# PROJ ADDRESS: <br />rna•- <br />DESCRIPTION OF _= <br />PROPOSED WORK: Short Plat 1.202-0; —07 <br />Permit to corane. wate(3/4"); amide ,only <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 ours in advance. <br />2. All work shall be performed in accorda a with this permit an current'City of Everett j <br />gn and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 4 hrs. before u dig. TOL FREE NUMBER 1-824-5555 <br />4. 'phis permit is -onlyrr <br />5. Another permit is req. <br />driveway paving et(--,. I <br />-cr he :t; -r and side sewer fro n <br />ireI3 for <br />11 otherr: fr�an ag <br />t J.-on. <br />improvements, drai-sad <br />I M <br />� re <br />°t <br />n�. <br />` !/` ACKNOWLEDGEMENT OF CONDITIONS <br />'--T , / The undersigned owner/applicant hereby agrees to hold and <br />v3 ^`1 save harmless the City of Everett from any and all claims for <br />edamages, costs, expenses, or causes of action that may arise <br />Approved forr C Constructioon Date" 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 C•ty'and to replace public <br />FINAL INSPECTION property"�Iamaged thereby. <br />Approved as Constructed Date <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 />M <br />0 <br />z <br />0 <br />Cn <br />0 <br />a <br />