6120 FLEMING ST 2016-01-01 MF Import

Date � z 9 � Applicatlon For PUBLIC WORKS PERMIT Print or Type Only PuClic Warks Parmlt • BItl9� Depl. k 4� / Z%� % Public Worka Fee Talel Fee � Lena ApP� Fee GaIC .g Balance Due S City Zip �'�y c�P Phone Desc�ibe Proposed Work oZ.—SIC�Y�1 /?/N/Y. � A k{��jLL� Project Address (if known) Attach tour (4) copies of plans for proposed work - Draw to scale and note the following as applicable: • Property Lines • Outline and dimensions of all existing and proposed structures on the lot • Existing and proposed utilities • Centedine of street • Indicate North • Show any proposed grading changes • Show measurements PERMIT CONDITIONS 1. All cells for inepection shall be made 24 hrs. in advance - phone 259•8810. 2. All work ahell be performed in eccordance with this permit and current City of Everett Design and Construction Stendards end Specifications. 3. C:all Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-4245555. %�v� Gvor/�- f��fi Nel~�e� � -aG- 9i q'�oi.C�wc/�_ Approved for Construction Date FINAL INSPECTION Date Approved as Constructed ��PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett. WA 98207 Phone: <59-8810 ACKNOWLEDGEMENT OF CONDITIONS W � � � O � � O 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 oi installation and maintenance of the improvement or other right-of•way us� hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTtD WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCEILED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.