5826 EAST DR 2018-01-02 MF Import

Qate#1 W q Application For PUBLIC WORKS PERMIT Print or Type Only Mailing Mailing Describe Proposed Work fi City Zip Zip Public Works Permpe •• '+ ? Bleg. Dept. • —lQ Public Works Fee Text Fee $ — Less Appl Fee Paid $ Bel.Dee $ Project Address lit known) .5876 1.94B — Attach four (4) copies of plans to, proposed work - Draw to scale and note the following as applicable: • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate Noah proposed structure: on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements for Phone Phone PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance - phone 259-8810. 2. All work shall be performed in accordance with this permit and current City of Everett Design anrt Construction Standards and Specifications. 3. Call Location Underground Service 48 his. before you dig. TOLL FREE NUMBER 1-800.424.5555. FINAL INSPECTION Approved as Constructed eveuat PUBLIC WORKS DEPAR 3200 Cedar Street Everett, WA 98201 Phone: 259.8810 U7� MENT Date ACKNOWLEDGEMENT OF CONDITIONS W H z O O a The undersigned owner/applicant hereby agrees to told 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 the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice Ircm the City and to replace public property damaged thereby. Sfgnalur of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER 15 TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.