7601 EVERGREEN WAY SPORTS PLUS 2018-01-02 MF Import

DateZ-n Application i-or PUBLIC WORKS PERMIT Public WDds Perm, • I 1r� Public Woks Fee TDIAI Fee $ Less ADDI. Fee Paid $ rPrint or Type Only I 9alan<e Due $ caner Mailing Address City ° Zip Phone Applicant Mailing Address City Zip Phone Describe Proposed Work ICI]' Ly 1 l A _I V7f-1 ✓) ��x"NV �-'� FK b _ Q Project Address (if known) Attach four(4) copies of plans for proposed work - Draw to scale and note the following as applicable: • Property Lines • Outline and dimensions of all existing and s Centerline of strcer• Indicate North proposed structures on the lot • Show any propose' grading changes • Existing and proposed utilities • Show measuremet r+re.� /� DO NOT WRITE BELOW THIS LINE W PERMIT CONDITIONS .O 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 Construction1� Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. Approved for Construction Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 Phone: 259.8810 vI-Y5I rc-a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, costs. expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant Dale 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.