5810 FLEMING ST 2018-01-02 MF Import

Date') A.:5-12 O Public Works Permit • I Application For iBme. Deft. « �/ ' / PUBLIC WORKS PERMIT ;� �'�� PPbTotal Fee Fae /Z J P___ „ r Less APPL Fee Paid $ Print or Type Only Balance Due $ lso,y� Owner Mailing Address City Zip Phone l a Applicant Mailing City Phone -Address [ l /Zip Describe Proposed Work LU 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 ,. Im DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS O 0 1. All calls for 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 Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424.5555. 4. App(oved for Const ctio Date FINAL INSPECTION Date Approved as Constructed everet[ PUBLIC WORKS DEPARTMENT r Cedar Street Everett, WA 98201 Phone: 259.8815 ACKNOWLEDGEMENT OF CONDITIONS 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 mainnc6 of the improvement or other right-0 -Way use hereto applied )or and further agrees to remo a same up?h notice from the City B7d to replace public pepe ty da aged thereby. 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 PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.