8814 EMERSON PL 2016-01-01 MF Import

� ., . ....__. �BtQ_�� r , ' 1 P�pLc Work�Parml t Application For Bwa.oeot.• — / PUBLIC WORKS PERMIT PuElicWorkaFee — Tolel Pea s Leu Appl Fee P�iO s Print or Type Only e.�."`°o"° s �,�r�,..�� '�I� �n-, 7�(. ��1 - �3�� wner MaiNng Address City Zip Pho�e � h�R.. Applicant Mailing Address City Zip Phone Describe Propoaed Work -^'Y� C� Ct2.�-c'�� Froject Address(il known) � � � � i�tiech four(4)copies oi ptens lor proposed work- Draw to scale and note the following as applicable: � • Property Linee • Centerline of street � • Outlinn and dimensions of al�existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utllities • Show measurements � DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS O 1. All calls for inspection shell be made 24 hrs in advance• phone 259•887 5. � 2. All work shall be peAormed in accordance with this permit and current City of Everett Design and Construction Standards and Specilicationa 3. Call Locatiun Underground Service 48 hrs. belore you dig.TOLL FREE NUMBER 1-800•424•5555. � O f�LJ ��,c�ir� �JoT ,E'Fq��2�-� �J/8� �. �u�v � a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett Irom any and all claims for damages, costs, expenses, or causes of action that may arise because ol installation and maintenance ol the improvement or other right-of-way use hereto applied lor and lurther agrees to remove same upon notice irom the � Approved tor'Construction Date City and to replace public property damaged thereby. FINAL INSPECTION Date Approved as Constructed Signature of Applican': Date everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN � 3200CedarStreet 1&0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO Everett,WA 98201 BE OILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE Phone: 259-8815 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON 7HIS PROJECT OVER 90 DAYS DURATION.