305 SE EVERETT MALL WAY MORGANS BIBLE MUSIC 2016-01-01 MF Import

Date� � Application For PUBLIC WORKS PERMIT Print or Type Only Applicant Address c��y City Describe Proposed Work ��EiQ K'J��pti� � Prolect Address (il known) _ � — '— " " � • " ,/ Attach four (4) copies of plans for proposed work •!`. ��'�'� scale and note ihe following as • Property Lines • Outline and dimensions of all existing a�itl proposed structures on the lot � Existing and proposed ulilities C PUDI¢ Works Permit�� eiec. oea�.• C9 c% Pubbc Wada Fee s Tolel Fee Less FppL Foe Paid S Bainncc Due s • Centerline ot street • Indicate North • Show any proposed grading changes • Show measurement� Phone PERMIT CONDITIONS 1. All cells 1or inspection shell be matle 24 hrs. in advance • phone 259-8810. 2. All work shall be performed in accordance with this permit and current City ot Everetl Design and Construction Stendards end Specifications. 3. Call Lxation Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424•5555. Approved for Construction Date FINAL INSPECTION Date Approved as Cunstructed evere[t PUBLIC WORKS DEPARTMENT � 3200CederStreet Evcrett, WA 98201 Phone: :59•BA10 ACKNOWLEDGEMENT OF CONDITIONS W H � � � O � � O a The undersigned ownedapplicaM hereby agrees to hold �nd save harm- Iess the City ol Everett Irom any and all claims for tlamages, costs, expenses, or causes of action thal may arise hecause of installation and mainlenance of the improvement or other right�of-way use hereto applied br and further agrees to remove same upon notice irom the City and to replace public property damaged thereby. Signature ol Applicant Date WORK AUTH0111ZED BY THIS PERMIT MUST BE S7ARTED WITHIN 7b0 DAYS OF L�ATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY F'�1RSUED TO COMPLETION. THIS PERMIT MAV BE CANCELLEU BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OV[R 90 DAYS DURATION.