120 SE EVERETT MALL WAY 2018-01-02 MF Import

/ Datec%�[�� qpplication For PUBLIC WORKS PERIliIIT Prir,"t or Type Only i� 13.Yc, SE �.! C • PuUlic Worka Permll + �/ � �� ` Blep. Dept y Public WorkS Fea s Tolal Fee Less FpP� Fae Paid $ �'vv�� Baianca Due S S�� Aoolicant �dailing Address � City Zip Phone Project Address (if known} Atlach four (4) cop�es of plans for proposed work - Draw to scale and note the following as applicabl=: � Prop�irry Lines • Outline and dim^nsions of all existing artl proposed siructures on the lot • Existing and proposed utilities i i:entedine ot street • Indicate Norih i Show any proposed grading changes w Shov+ measuremeNs PERMIT CONDITIONS 1. All calls (or inspectien shall be made 24 hrs. in advance - pfione 259•881 5. 2. All work shall be perlormed in accordance wi:h this permit and current City ot Everett Design and Construction Standards and Specilications. 3. Call Localion Underground Service 48 hrs. before you dig. TOLL FREE hUMBER 1•800•424-5555. y �GI� �Ti�%�iE'O�zO �C�/1'V, a�j�.�3 FINAL INSPEGTION / \ x Approved as Construcled \�� O eveiett PUBL!C WORKS DEPARTMENT � 3200 Cedar Street EvereU, WA 98201 Phone: 259-8815 �6 Date -l7�8� Date ACKNQWLEDGEMENT OF CONDITIONS w W H � � � � The undersigned owner/applicant hereby agrees to hold and save harrn- lass the City of Everett from any and all claims for damages, cosis, expenses, or causes ol action that may arise because of inslaltati�n and maintenance of tha improvement or other righl-of-way use hereto applied for and lurlher agrees to remove sa e upon notice from the City and to replace public property damage t er by. � g tu o Applicant Date pRK AUTHORIZED BY HI ERMIT IvSUST BE STARTED WITHIN 180 DAYS OF DATE PEfiM1T IS ISSUED AND TNEREAFTER IS TO BE DILIGENTLY PURSUED TO CO�IPLETION. TFiIS PERMIT MAY BE CANCELL ED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRO,iECT OVER 90 DAYS DURATION.