7815 EVERGREEN WAY PACIFIC LINEN 2016-01-01 MF Import

Date� 6 � Application For PI�BLIC WORKS PERIVIIT Print or Type Only Mailing Malling Describe Proposed Work Projecl Address (if known) � Altach four (4) copies of plans for proposed work- Draw to scale and note the following as applicable: • Property Lines • Outline and dimensions ot all existing and proposad siructures on the lot • Existing and proposed ulilities Pu�lro WOBs Permit r /+ Biee. Dent. r .�' (e �%%�i il�_ Puolic wo�ks Fno § Total Feo Less Appl. Foe PeIE $ — Balunce Duo $ • Centerline of street • Indicate North • Show any proposed grading changes • Shov+ measurements rnuue PERMIT CONDITIONS 1. All calls for inspection shall 6e made 24 hrs. in advance - phone 259•881 5. 2. �II work shall be performe� in accordance with this permit and current City ol Everett Design and Construction Standards and Specilications. 3. Cali Location Underground Service 48 hrs. hefore you dig. TOLL FREE NUMBF:H 1-800•424•5555. Approved for Construction Date FINAL INSPECTION Date Approved as Constructed e��erett PUBLIC WORKS OEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone:259-8815 �4l��ii �� �� ACKNOWL D EMENT OF CONDITIONS W H � � Z � � � � a The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from aiiy and all claims lor damages, costs, expenses, or causes of aclion lhat may ariso because of inslallation and maintenance of the improvement or other right•oi-way use hereto applied for and lurther agrees lo remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant Dale WORK AUTHORIZED BY THIS �'ERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMI�f IS ISSUFD AND THEREAFTER IS TO BE DILIGENTLY PURSUEC TO COMPLETION. THIS PERMIT MAY Bt CANCELLED BYTHE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.