3924 FEDERAL AVE 2016-01-01 MF Import

oete —3� / Application For PUB�.IC WORKS PERMIT Print or Type Only �J A, Describe Proposed Prolecl Address (if known) �j �, , Publlc Works Pe�mll • BIEO. Dapl, i Public Works Fee S Tolel Fee Leee AppL Fee Peltl S Balance Due � �� Zip Phone Attach four (4) copies af plans for proposed work • Draw to scale anA note the following as applicable: • Property Lines • Centerline of sireet • Outline and dimensions of all exisling and • Indicate NoAh proposed structures on ihe lol • Show any proposed grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calis tor Inspeclion ahall be made 24 hrs. in advance - phone 259•8810. 2. All work shell be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specificetlona 3. Cell Locatlon Underground Service 48 hra betore you dig. TOLI FREE NUMBEH 1-800�4245555. � .�� .�.w�-�� . �;��- .�o�,�.,� «�� �5�;,�i .��.� �.�«�.� , �tiv Approved FINAL INSPECTION Approved as Constructed %� PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everelt WA �38201 Phone: 259•8870 ZJ' %i Date /G—//- �/ W H � � Z' O'�� � � 0 a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm• less lhe City of Everett from any and all claims for damages, costs, expenses, or causes of ar,tion that may arise because of installation and maintenance of the improvement or other right-of•way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. � V�ORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THERF.AFTER 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. -