2010 ADAMS AVE 2016-01-01 MF Import

oate 4-�t -44 u I� � 4/13� -- � -� � Public Work�Pa�mi11 � Applicatio�For Bmp.Deo�-� �4'��O PUBLIC WOR�(S PER11�1POSTING `�� ``" � ,�„,o,,,,., � TotalFee = � Leae ApDI.Fea PpiE S Print orType Only r � � g S � � S g bmanceDue t ZO ' a � � � � � � � � � -fh Tr wR �r �iJ X 3014 � Wi� 98203 3t7-71 Owner MaiN\Ad ss � � � C�,it� Zip Phone � � � � � � � � � � �5 Ap0licanl Mailing Address City Zip Phone � DesCribe Proposed Work �UY Neusl� l-ot � 5P Z-q3 Prolatt Address(if known) 2�� A DA�M S f�V� � I. Attach four(4)copies of plans br proposed work-Draw to scale antl note the following as aRP��cable: � I�' • Propehy Lines • Centerline of street � � I, •Outline and dimensions ot all existing antl • Intlicate North �� proposed 5tructureS on the bt • Shou�any proposed grading changes � • Existin9 and p�oposed utilities • Show measurements � DO NOT WRITE BELOW THIS L�NE O I PERMIT CONDITIONS I 1.All cells}or iesp9ptipn g�ell be mede 24 hB.in advenCe-phone Y$��O. � I 2.All work ahall be peAormetl in accordance with thia parmit end current Ciry of Everett Design and Construction StendaM3 end Specification& 3.Call Location Unde,ground Service 48 hrs.betore you dig.TOLI RREE NUMBER 1•800�4245555. � 4. ?��e dr:v�w� -�o+n ed� o� �,..en,c,�t ;�+ 2ow � �rc�er-�y �:n.�. O � I O ! a �� ACKNOWLEDGEMENT OF CONDITIONS �II The undersi9neA owner/applicant hereby agrees to hold and save harm- �I, less the City o� Everett Irom any and all claims for Oamages. costs, '� expenses. or causes of action thet may arise because of instaHation I �_ 0 �LV__ A Z�/q� antl maintenance of the improvement or other right-of-way use hereto 1-��~� � � `T� applied for and further agrees to remove seme upon notice lrom the P.pprov r Cons tion D�— Ciry and to replace public property damageE thereby. , /f � INSPE 10 � O D e (��t`1.E,`"�.�_��— �� ApOroveO as ConstructeC atu o�Appli fnt � Dete I PUBLICWOiiK3DEPARTMENT R AUTHORI2�D BV THIS PERMIT MUST BE STARTED WITHIN I 3200Cedar3treet I 1 0 DAVS OF DATE PERMIT �S ISSUED AND ?HEREAFTER IS 70 i EverotR WA9B20/ BE DILIGENTLV PURSUED 70 COMPLETION.THIS PERMIT MAV BE . P��ona:259-8810 CANCELLED BV TME CITV UPON ANV BTOPPAQE OF WORK ON THtS PROJECT OVER 90 DAVS DURATION.