3007 FEDERAL AVE 2018-01-02 MF Import

q \/ .<a..:.:......�o-......._,, .. .,, ._�, ..c.:....,y.a.....ar:Y.ia.U�szn:::.::[r+-Jirw:r.G:..aG:.•r_a.:nr.u....... �xau.a.atYarY..:.�:,:.u.:....., .,. _..... a Date�lo t ,, ` � /yam/ Public wake PMMI sift DWL • --�—.� Application For PUBLIC WORKS PERMIT "' W` Fee T"'"• LaPaW : earns Dw Print or Type Only Describe Proposed Work Project Address (if known) Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading Changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls for Inspection shall be made 24 hrs in advance - phone 259-8815. 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specification& 3. Call Location Underground Service 48 hr& before. you dig. TOLL FREE NUMBER 1.800.424.5555. or' -5 v� C;J NCH of 115 Approved for Construction Date FINAL INSPECTION Date Approved as Constructed WeverettPUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 ACKNOWLEDGEMENT OF CONDITIONS � d7�-- The undersigned owner/applicant herebi agrees to hold end save harm• less the City of Everett from any ii claims for'damages, costs, expenses, or causes of action that Viay arise because,of installation and maintenance of the improvement or other-right•of-way use hereto applied for and further agrees to remove same upbi notice from the City and to replace public property damaged thereby.: Signature of Applicant Dale WORK AUTHORIZED BY THIS PERMIT MUST BE •STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AWTHEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS Pon icrT nVPQ On T)AYS nI IRATION W H ca O^ z O N O a ..J I