1402 SE EVERETT MALL WAY CITY SWEETS 2018-01-02 MF Import

RtPm CIE M H O N { 1am w I low Date (y 7f90 Application For PUBLIC WORKS PERMIT Print or Type Only City sweets Describe Proposed Work Tn02 sta Everett Nall Way - #9C t Publld Works Permit* .�—�— eidg. Dept 490/24840 Public Works Fee It —� Total Fee Less APPI Fee Paid $ ��- Project Address fit known) Attach four (4) copies of plans for proposed work • Draw to scale and note the Centerlinefollowing of as applicable; • Property Lines • Indicate North • Outline and dimensions of all existing and 0 Show any proposed grading changes proposed structures on the lot a Show measurements • Existing and proposed utilities .,.. unT IMPITF RFLOW THIS LINE Phone PERMIT CONDITIONS 1. All calls for inspection shall be made 24 a ' it advance • phone 259.88 2. All work shall be performed In accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 5. 3. Call Location Underground Service 48 hrs. (:efore you dig. TOLL FREE NUMBER 1.800.424.555 �'saw,;I. Date Approved for Construction Dale FINAL INSPECTION Approved as Constructed W PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett WA 98201 Phone: 259.8810 cP PO FM Cl) 0 M 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 and maintenance of the improvement or other right-of-way use hereto applied dfor and further agrees eto rdemolie same upon amaged hereby. notice from the City repl ce Date Signature of Applicant WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO IT MAY BE THS PERM CANCEL EDT LY BY THE CITY UPONPURSUED TOOANY STOPPAGEIOFWORK ON THIS PROJECT OVER 90 DAYS DURATION.