1402 SE EVERETT MALL WAY LIMBER LADY 2016-01-01 MF Import

Datell_��lL� Application For PUBLIC WORKS PERMI�' Prini or Type Only Applicant Describe Proposed Work Prolect Address (if known) Mailing Address City Atlach four (4) copies of plans for proposed work - Draw tc scale and note the fo�lowing as applicat�l.h: • Property Lines • O�tline and dimensions cf all exisling and proposed struclures on th2 lot • Existing and proposed utilities Pu�Lc Wo�hs Perm�l < �j Bldg Dept � �r�J _ Pu�bcWorkSFee 5 Tolal Fee _ less Fppl. Fee Paitl $ _ 6aiance Due S • Centerline of streel • Indicate Norih • Show any proposed grading changes • Show measurements Phone PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance - phone 259•8810. 2. All work shall be performeC in accordance with this permit and curreni City of Everetl Design and Consiruction Standards and Specitications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424•5555. Approved fcr Construdion FINAL INSPECTION Approved as ConsVucled evere[t PUBLIC WORKS DEPAATMENT � 3200 Cedar Street Eve�ett, WA 98201 Phone:259-8810 1 �V I / }:— �� 1 ~-t� � Date Date 1 ,L �� �if _ � c`3� ACKNOWLEDGEMENT OF CONDITIONS �' The undersigned owner/applicant hereby agrees to hold and save harm- less ihe City of Everett irom any and all claims for damages, costs, expenses, or causes of ac�ion that may arise because ol installation and maintenance ot ihe improvement or o�her righ�-of-way use hereto applied tor and lunher agrees to remove same upon nolice Irom the City and to replace public properry damaged thereby. Sipnature of Applir,ant Date WORK AUTHOR�ZED BY THIS PERMI�I UST BE STARTED WITHIN 180 DAl'S OF UATE PERMIT IS ISSU� �ND THEREAFTER IS TO BE DILIUENTLY PURSUED TO COMPLETION. THIS PERMIT �.1AY BE CANCELLE7 BY THE CI7Y UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.