851 N BROADWAY 2018-01-01 MF Import

Date��i Application For PUBLIC WORKS PERMI�' Print or TypP Only LL qddress Uiry ,�_ � PuOhc Wo�Fe Pe�mjil �• Blap. Dapl � �j s(J�� PuEuc wort� Fee To�� .e s —. Lae� Aoo� Fee Pn�C S Belance Due �. . � . �i�1llu7it!.L�—i��i� —.oiia�r�r---� �� — � �i ♦ / - � Projec� Aa iress (il known) � , �r��w �� Attach lour (4) copies ol plans for proposed work - Draw to scale and note the following as applicable: • PropertY Lines • Outline and dimensions of all existing and proposed s�ructures on the lot • Ezisting and proposed utilities PERMIT CONDITIONS • Cer•�adine of street • Indicate North • Shov any proposed grading changes • Show measurements 1. All calls for inspection shall be made 24 hrs. in advance • phon,= 259•881 5. 2. All work shall be pertormed in accordance with this permit �+nd c�rrent City ol Everett Design and Construdion Standa-ds and Specificalions. 3. Call L.cation Underground Service 48 hrs. belore vou dig. TOLL FREE NUMBER 1•800•424•5555. 5� r�l/fGiG �D,F-,f s� f�,�m:7� NaT ,PFqUi,ec-.•o Approved for Conslr�ction FINAL INSPECTION Approved as Constructed everett PUBLIC WORKS �EPARTMENT � 3200 Cedar Street cverett, WA 98201 Phone:259-8A15 Date �'� ACKNOWL[DGEMENT OF CONDITIONS W F- � � O � � O a The undersigned owner/applicanl hereby agrees to hold and save harm� less the Gly of Everett from any and all claims for damages, costs, eapenses, ot causos ol action ihat may arise because of installation and maintenance of the improvemenl or other righPof-way use hereto appl;ed for and further agrees to remove same upon nmice irom the City and to replace public property damaged thereby. Signature ot Applicant Date WORK AUTNORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERIvIiT IS ISSU[D AND THEREAFTER 1S TO BE DILIGENT�Y PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BV THE CITY UPON ANY STOPPAGE OF WORK ON ThIIS PROJECT OVER 90 DAYS DURATIO�'.