11030 EVERGREEN WAY 2018-01-02 MF Import

Application For PUBLIC WORKS PERMIT PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 (425) 257-8810 TYPE OR PRINT ONLY Date I—.Kq_ Public Works Permit 11 Z Building Permit N Public Works Fee $ S3 F - HIctlAel R, MA,i1140 510 RAINIER Age J SEhITLE k1A 28144 (1-06)123- 539' Owner Malting Address City I Zip IPhone KvSSMA/J AgScC./A.TFs Pro fox 17D5 (3ort+FLL tA.�A98041-1705 (425�48(o-%300 Applicant Mailing Addrass Ciry Zip Phone Describe Proposed Work. I a I TI At C Le^rWAJ F RAC I TE S �, AN W M iri CrA•T-t oN Eb rL ifA—M.— eT AP/�2.TM£AITS U) PROJECT ADDRESS (if known) NU)Y 9 A )o II2T1t- STiLzEr S.W M Attach four (4) copies plans for propcsed work - Draw to scale and note the following if applicable: O • Property Lines • Outline and dimensions of all existing and proposed structures on the lot • Existing and proposed utilities • Centerline of street • Indicate North • Show any proposed grading changes • Show measurements DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS: O 1. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. ♦A J on io FINAL INSPECTION Date' Approved as Constructed ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harmless 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 ra ppve Vng uporyaotke frgm the City and to replace public property dam - WORK AUTHOREED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS'bF DATE issu D"ThEREAFfER IS TO BE mice ILY RIRSUED TO COMPLETION. THIS PERIAIT MAY BE CANCELLED BY THE CRY UPON ANY STOPPAGE ON THS PROJECT OVER go DAYS DURATION.