11030 EVERGREEN WAY 2018-01-02 MF Import

Applkatlon For PUBLIC WORKS PERMIT PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 (425) 257-8810 TYPE OR PRINT ONLY DEC 2 6 2002 16 f •.i:11c !U Date f4S Public Works Permit ff AVA Building Permit # Public Works Fee $ z0gV' 701., 6 9 M" IT,',-CS,Crr 7es 4710 A .ljer b-[ i. _5'ee 1/e C,//t y,t Owner Mailing Address City Zip Phone Applicant Mailing Address Ciry Zip Phone Describe Proposed Work , )- / W ttttttttttt� U) PROJECT ADDRESS (if known) -Evr <, off' /4c. / 9y _ M Attach four (4) copies plans for proposed work - Draw to scale and note the following if applicable: 0 • 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 Z 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. r 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. ♦ ) a FINAL INSPECTION Approved as Constructed Date 12-01-99 12: OTHER f lJ,`SVuI y� PW/ItiSP M-. - 'T9 65, >f 0M.b 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 remove same upon notice from the ity and to replace public property dam- aged thereby. 2 grwwe or App� WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMR IS ISSIEDAND THEREAFTER ISM BE DiLr"rLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY rHE CITY UPON ANY STOPPAGE OF WORK ON THIS PROtECT OVER 90 DAYS DURATION.