1021 CROWN DR 2016-01-01 MF Import

, ilicetbn Fa � PUBLIC RKS PERMIT oetBC'. 8-30-96 - PUBLIC WORKS DEPARTMENT Pubiic Worlcs permtt M 3200 Cedar Shset Everett,WA 98201 259-8810 g��ying Permk M 52752 TYPE OR PRINT ONLY Publk Worlcs Fee S Moser, Stan 1021 Crown Dr Everett 98203 258-7977 Owner Maliing Address City Zip Phone Owner Applicant Mel�ing Hddress Ctty Zip Phone Describe Proposed Work Znd etory addn ■ ■ ■ W �"' � � PROJECT ADDRESS(if known) 1021 Crown Dr � Attach four(4)copies oi�'ans for proposed work-Draw to scale and note the tollowing N eppikable: O •Pro{ierty Llnes ':�utline and dimensions of all existing end proposed stru:tvres on the lot •Existfng and pioposed utllkies 'Cenlerline oi�trt=1 •Indicale No�th 'Show any poposed gradi�ig chenges 5how measurements � DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS: Z 1.All calis for inspection shall be made 24 hours in advance- phone 259-8810. O 2. All work shall be performed in accordance with this pertnit and current City of Everett Design and Constniction Standards and Specificatfons. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. H � O �o �W �,� �� a � �� ACKNOWLEDGEMENT OF CONDITIONS The undersigned ownedapplicant hereby agiees to hold and save hermlesa the City oi Everett from eny and all claims for demages,costs,ezpenses,a Approved for Construction Date ceuses ol action that may arise because of instelletbn and maintenance of the improvement a other rtghtroi-way use herato appibd for and lurtlbr agrese to remove same upon notice hom the City and to repiace publb property damaged ihereby. FINAL INSPECTION Date Approved as Constructed Signature ot Applicant Dete WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DIIJGENTIY PURSUED TO COMPLEf10N.THIS PERMIT A1AY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.