2315 W CASINO RD 2018-01-02 MF Import

Date! r ls_ Application For PUBLIC WORKS PERMIT Print or Type Only Mailing Address Applicant Mailing Address Vry Public Works Per It e eldp peer • _ Publm Worke Fee S Total Fee Less ePPI for Plud S Belaoce Due $ Zip P City Zip Phone Describe Proposed Work —Ala ��!_(24C r `.LZ Project Address lit known) Attach four (4) copies of plans for proposed work - Draw to Scale and notP the following as applicable. • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls for Inspection shall be made 24 hrs. in advance - phone 259.8810. 2. All work shall be performed In accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Cull Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800-424.5555. Approved for Construction FINAL INSPECTION Approved as Constructed i PUBLIC WORKS DEPARTMENT Evertt,WA 8201 treet Everett, WA 98201 Phone: 259.8810 ror 1*irw Date ACKNOWLEDGEMENT OF CONDITIONS W I- 0 n Z 0. 0 a The undersigned owner/applicant hereby agrees to hold and save harm less the City of Everett from any and all claims lot damages, costs, expenses. or causes of action that may arise because of Installation and maintenance of the improvement or other right-ol-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Date Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE. PERMIT 15 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.