6006 FLEMING ST 2016-01-01 MF Import

Date_ �� Print or � Application For PUBLIC WORKS PERMIT Only Describe ProposeC Work Project Address (if known) PUEIic Works Fprmlt � eieu. oec�. x _ ,1 PuDlic Wprks Fee � To1el Fee S _ , Lees ApO� Fee PaiO S Palance Oue � Zip Phone � S� � �/6� /� Zip Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: • Property Lines • Centedine of strr�et • 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 rnone 7. All calls for inspection shell be made 24 h�s in advance • phone 259•8815. 2. All work shall be pertormed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underg�ound Service 48 hrs. before you dig. TOLL FREE NUMBER 1-$00•424•5555. /%G �U6'�_ i c 1,v0,�',�-s �'F,�:niT ,�Fcr�r,� �� � �� �� Approved for Construction Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Ceder Street Everett, WA 98201 Phone: 259•8815 ACKNOWLEDGEMENT OF CONDITIONS W H � � O � � 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 ihe improvement or other right-of-way use hereto applied tor and further agrees to remove same upon notice trom the City and to replace public property damaged thereby. Signature of Applicant 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 PERMIT MAY 8E CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON ?HIS PROJECT OVER 90 DAYS DURATION.