8609 EVERGREEN WAY 2018-01-01 MF Import

Date�L10� t l a�oi��vo�k:c„� + � oino.o�ai.. �/�- �pplicaticn For PUBLIC WORKS PERiViI�' PuoTo�IFeeFe� s_ lesSApPI FUePoiO $L� �lltllfl��111! J Print or Type Only - � ��( �> u i � � r WC�IX A� Owner Maiiin Address City 2ip Phonc �/).VY 1,4 - Applicant Mailin�Address Ci�y Lp Phone Describe Proposed Work � -� W ProleclAddresslilknown) � �r' �� H Attach lour�4)copies ol plans�o�p�oposed work- Draw to scale and nole Ihe followi� applicable: � • Pmoerty Lines • Centerline ot s�reet /^ Y Omline and dimensions ot all exisling and • Indicate Norlh V� proposed structures on the lot • Show any propused grading chr,nges • Existing and proposed utilities • Show measurements � DO NOT WRITE BELOW THIS LINE O PERMII CONDITIONS 1.All calls tor inspection shall be made 24 hrs.in aJvance-phone 259•8810. I� 2.All work shall be performed in accordance wilh this permit and current City of Everett Design and Construction ♦ S;andards an�Speciticati�ns. 3.Call Localion Underg�ound Service 48 hrs.before you dig.TOLL FflEE NUMBER 1•800•424•5555. � �� n� , o �, , �"'�''' , ,� �� � O � ACK�ONJLEDGCA1ENT OF CONDITIONS Tht:�undersi��netl ovrner/applican�hereby agrees to hold and save harm- -- Iess ihe Cili ol E�erett Irom any and all claims for damac�es. costt. exUenses, [r causes ot aclion Ihat may ari<_^ because of installation and maintena�:ce of the ;mprovemen� o� other righbof-way use herelo appliea lor and further �9rees to remove same upon nofice trom the Approved lor Construc�ion �a�e Ciry and to replace puhlic oroperty damac�ed ihere6y. FINAL INSPECTIOPI Dale — Approved as Constructed Signature of AGplicant Da�e WORK AUTHOP,IZED BY THIS PERMIT MUST BE STARTED WITHIN everett PUBLICWORKSGEPARTMENT 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO � 3:OOCedarStreet BE DILIGENTLY PURSUED TO COMPLETION. Tf115 PERMIT MAY BE Everett,WA98201 CANCELLED Bl'THE CITY UPON ANY STOPP�GE OF WORK ON THIS Phone:259�8870 PROJECT OVER AO DAVS DURATIC".