6231 W BEECH ST 2018-01-02 MF Import

Date--Ct,�11�N C AnnhcaGon for PUBLIC WORKS PERMIT Print or Type Only Aocress Pubec Work* Pelmd • Bldg owl • _-_��/ Pubic Wore* Fee Total Fee Leo ♦W1 Fee P•Id s Balance Due $ Describe Proposed Work _ 4/0 1A 9 _C_.__`l,�_�- Project Address (if known) --(R� Attach lour (4) copies of ol.sns for proposed work - Draw to scale and note the following as applicable: • Property Lines • Centerline of street 0 Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes A Existing and proposed utilities • Show measurements phone Phone PERMIT CON DIT1014S 1. All calls for Inspection shall be made 24 hot. In advance- phone 259•111810. 2. All work shall be performed In accordance with this permit and current City of Everett Design and Construction Standards and Specltkalions. 3. Cvll Location Underground Service 48 hrs. befote you dig. TOLL FREE NUMBER 1.800.424.5555. Approved for Constuuction FINAL INSPECTION Approved as Constructed r•vrn•n PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett WA 98201 Phone: 259.8810 Date Date ACKNOWLEDGEMENT OF CONDITIONS W 0 ass!) z 0 r� C/ 0 a The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, costL expenses, or causes of action that may arise because of installation and maintenance or the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City ar•d to replace public property damaged thereby. Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE , CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.