1618 EDGEMOOR LN 2018-01-02 MF Import

_ o --270 Date `",-/ - U Public Works Permit# �� Application For Bldg.Dept.# PUBLIC WORKS PERMIT Public Works Fee Total Fee $ Less Appl.Fee Paid $ • Print or Type Only Balance Due $/ 4 CA/A.el� / ) 6_r'7L L , ..k7, g( 7z 2.`p- l 7t jlye -L4," ..r.30 -fr,,3 G.8Z? 6 Owner Mailing Address City Zip Phone Sws,-,� 6-6 e- �7 Applicant Mailing Address City // Zip Phone Describe Proposed Work ' Hj-'/44 Y1 Q J _��r^ S .�J _•��e -re e, r 746 6 L / 1~,� .S7 , LLI Project Address(if known)C497- r16.-- -4-Vie m 00 r I./ 4 4 '-- ye ✓- .),(1/ Attach four(4) copies of plans for proposed work- Draw to scale and note the following as applicable: • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North co proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • • Show measurements CO DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS 0 1. All calls for inspection shall be made 24 hrs. in advance- phone 259-8815. 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction 1115 Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800-424-5555. ow limn amo co 0 OM ACKNOWLEDGEMENT OF CONDITIONS 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 of installation � d6 and maintenance of the improvement or other right-of-way use hereto w c� applied for and further agrees to remove same upon notice from the Approved for Construction Date City and to replace public property damaged thereby. ��)F I SPECTION Date e .- a ( 86 •Approved as Constructed Signature of Applicant Date f 1 WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN everett PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE e . Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS J Phone: 259-8815 PROJECT OVER 90 DAYS DURATION.