9815 EVERGREEN WAY 2016-01-01 MF Import

Date T�� POSTING g" � y-5f Application For PUBLIC WORKS PERMIT Print or Type Only Mai4ing Describe Proposed Work P�oject Address (if known) Address � City .� // � Public Worke Parmil � 9y� aiaa. oapi. , Pu�lic Wo�ks Fee Totel Fea � _ Less Appl. Fee Paitl S� 9alnnco Due s � Zip - - Phone Attach four (4) copies of plann for proposed work - Draw to sc le and note the following as applicable: � Property Lines • Centedine of street • Outline and dimensions of all existing and • �ndicate North propose structures on ihe lot �7,'-�"',�9� -�^� �--.� n,�".;� �._o:,p, • Show any p�oposed grading chapges�� - � � ''' `- • Existing and proposed utilities • Show measurements Approved as �A� PERMIT CONDITIONS '�'�='�'�� 1. All calls for inspection shall be made 24 hrs. in advance - phone 259•8810. l"�� ^` ''�� '�-1 2. All work snall be performed in accordance with this permit and current City of Everott Desi ��,� �j � �� r�'�- 5=�� , 9nandC�onsfructwn ' Standards and Specif icallons. ; � , �i ,_.. _. 3. Call Location Underground Service 48 hrs. before you dig. TOL/L FR,EE NUMBER 1•$Op-�$i4:5555:��• �� ��Qi�Q �Q� �„�J �i�.�c .nn } �_. r.- '� --�'►' i a�� z-�o.g,�-,;�;� __ �. .. _,;�, .,.,.�.. PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 Phone:259•8810 Date _�._ , --��>>=- ACKNOWLEDGEMENT OF CONDITIONS W � � � � � � � 0 a The undersigned owner/applicant hereby agrees to hold and save harm- less 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 riher agrees to remove same upon notice from the City and !o reff(ace p 61ic property damaged thereby. WORK AU7HORIZED BV THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAF7ER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.