6214 FLEMING ST 2016-01-01 MF Import

Date�� / Application For PUBLIC WORKS PERMIT Print or Tyoe Only U. c�y�`' ��'j .`,7� Mailing Address City Mailing Address City Dsacrlbe Propose%' Work .�Y�:l� 7 �� `�� Project Addresa (If known? Publie Workn Parmll e � • �� em eot + PUEIic Warka ee a Totel Fee Le95 ADO� Fea Peltl S— �J� QO Belence0ua S._StLC� �. .; �Adaeh four (4i Copias of plana for proposed work - Draw to scale and note the following as applicable: . . � . � . • Proporty Lines . • Centerline of street � • Outline and dlmensions of all existlng end • Indicate North " pro{aeed atructures on the lot • Show eny proposed grading changes �� • Ezietinp and propoaed utilities • Show measurements PERMIT CONDITIONS 1. All Calls for Inspectlon ahell be mede 24 hrs in advance - phone 259•8815. 2. All work ehell be peAormed in acc xdecae with this permit and current Ciry of Everett Design and Construction � . . Standerde and SpeclHcationa 3. Call Location Underground Servir.e 48 hr& before you dig. TOLL FREE NUMBER 1•800-424•5555. 1� %i6N%Tli.�•4� �c+�'•Tc� �vi.�:� s�/rs i.dro cS�yGT�M ci/�(�Wit/ DN A7T/'C'.6'� �iY�/Il• Approvedfo� r Ap//p��rovW ee Coeetructed _. �PUBLIC WORK3 DEPANTMENT 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 Date ,l�.P.s�i.d.�s-,� ACKNOWLEDGEMENT OF CONDITIONS W H � � O � � O a The undersigned owner/applicant hereby agrees to hold and eave harm- less the City of Everett from any and all claims for demages, costa, r,,�,nses, or causea of action that may arise because of Inatallation and maintenance ot the improvement or other right•of-wey use hereto epplied for and further agrees to remove same upon notice f�om the Ctty and to replace public property d maged there6y. '.J � �� c / Signature of Applicant Date WQRK AUTHORIZED BY THIS PERMIT MUST 9E STARTED WITHiN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILI6ENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.