9129 EVERGREEN WAY 2018-01-02 MF Import

� Date�'L� �y Appllcation FOr PUBLIC WORKS PERMiT Print or Type Only y' Descri6e Proposed Work Project Address (if known) Address �, e Cily Attach four (4) copies of plans (or proposed work - Draw to scale and notr. ihe lollowing as applicat�le: • Property Lines • Outline and dimensions of all existing and proposed strucl�res on the lot e Existing and proposed utililies for PEHb11T CONDITIONS Public Woehs PBrm11 / C�` ` �— aiae� oeo�. • ; Public Worka Fee $ �7p�- Totel Fee Less Appl. Fee PaiC $ Balunce Oue $ o'U � • Centerline of street • Indicale North • Show any proposed gradin� changes • Show measurements 7 1. All calls for inspection shall be madr 24 hrs. in advance - phone 259-881 5. 2. All work &hall be performed in accordance with this permil and currenl Gity of Everett Uesiyn and Construction Standards and Specifications. 3. Call Location Underground Service48 hrs. hefore you dig. TOLL FREE NUMBER 1-800-424•5555. FINAL INSPECTION � \ . Approved as Constructed \ � - ) everett PUBLIC WORKS DEPARTMFNT / � 3200 Cedar Street Everett, WA 98201 Phone: 259�8815 Date ACKNOWLEDGEMENT OF CONDITIONS , � O Tha undersigned owner/applicant hereby agrees to hold and save harm� less the City of Everett liom any and all claims lor damages, costs. expenses, e� can�ac nf actinn that mav arise because ot installation and maintenance ol ihe improvement or other right-of�way use f�ereto applied for and lurther agrees to remove same upon nolice iron the City and ro replace public properry damaged thereby. re �C �� Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATG PERMIT IS ISSU[D AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CI�fY UPON ANY STOPPAGE OF WORK ON 7HIS ?ROJECT OVER 90 D.4YS DURATION. z 0 -� �. n m �-. .. �--I �l � --� N 2 m 0 �v mo c� -i r_ o -s f�l --I Z x -i m �z a -i r x .. .. �--� N < � O .T� � 3 --t m m.. N O or c� m c �n m� z c� -a r • m a A � 2 D Z � ^r � z 0 � � m