6218 FLEMING ST 2016-01-01 MF Import

Date�� Application For PUBLIC WORKS P�RMiT Print or Typo Only Public Wo�ks Parmlt t • =" _=t � 81 De04 r �! - P Public Warka Fae s Talal Fen LBas Appl. Fee PeIE S BalanceDua S �� O �� plicant Mailing Atldress City ZiP Phone De,cribe Proposed Work n �-u� �r�' � � Proleot Address (If known) 6�/8 `��l�/yG 'ST Attech four (4) coplea oi plans for proposed work • Draw to scale and nole the following as applicable: • Propsrty Lines .• Centerline of street • Outline end dimensions of all existing and • Indicate North proposed atruciures on the lot • Show any proposed grading changes �� • Exlatlnq end proDa�ed utilities • Show measurements PEHId1T CONC!i!ONS 1. qll calls for �nsper.tion ahali be made 24 hrs in advence • phone 259-8815. ' 2. All work ehell ba peAormed in eccordance with this permit and current City of Everett Des�gn ancl Censtruction - Standerda ae.� S;�eclFlcatlona . 3. Cell Locaticn Underground Service 48 hrs before you dig. TOLL FHEE NUMBER 7•800'424-5555. �% �7% /1i-u�� A` .nooF-ro�' Lba�N SPo[lTs /itiTo A.PA�.rJ�9oE .�isrc.•� � Sh'�r✓�/ o•� A�//9c.s�,a�o CyfJ.eT, �e Conatructed PUBLIC WORKS DEPARTMENT 3200 Cadar Street Everett, WA 98201 Phone: 259•8815 ACKNOWLEDGEMENT OF CONDITIONS W � � � � � The undersigned ownedepplicant hereby agrees to hold and save herm- less ihe City of Everett trom any and ell claims tor dameges, costa, expenses, or causea of action thet may erise because ot Inatalletion and maintenance of the impravement or other right-of-way uae heretc applied for antl turther agrees to remove same upon notice from the Cit and to replece public property demaged thereby. I �S/ ..� i� r� Signature af Applicant Date WORK PUTHORIZED BY THIS PEHMIT MUST B STARTED WITHIN 180 DAV'S OF DATE PERMIT IS iSSUED AND THEREAFTER IS TO BE DILIGENTLY PUFSUED TO COMPLETION. THIS PERMIT MAY Bfi CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON T✓� PROJECT OVER 90 DAYS DURATION. .