3700 FEDERAL AVE JACKSON ELEMENTARY 2018-01-02 MF Import

Date�Srf� -, Applicatlon For PUBLIC WORKS PERMIT Print or Type Only Address Describe P�oposed Work Prolect Address (if known) ,�-, PuOGc Worb Parmit • BIOp. Dept, f _ Pu01ie Work� Fee Tolel Fee = Lese Appl Fee Peid S Balenca Due 5 Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: • PropeAy Lines • Outline and dimensions of all existing and proposed structures on the lot • Existing end proposed utilities PERMIT CONDITIONS • Centerline ot street • Indicate North • Show any proposed grading changes • Show measurements t. All calls lor inspection shall be made 24 hrs. in advance • phone 259-881 5. 2. All work shall be performed in accordance with this permit and current City of Everett Desiga and Construction Standards and Specilicationa 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424-5555. �D � �¢2 ��?` ,�e d,u�,u� /G/�6 _¢. , 'J'" `� Approved for Construction Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 ACKNOWLEDGEMENT OF CONDITIONS W F- � � O � � � a The undersigned owner/applicanl hereby agree.; to hold and save harm- less the City o( Everett from any and all cla;ms 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 (urther agrees to remov-� same upon notice from the City and to replace public property dama3ed thereby. of Aoolicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PEflMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.