406 SE EVERETT MALL WAY CARBURETOR TUNE 2018-01-01 MF Import

Date1.LLL� 1 P.pplication For PUBLIC W�Rl�S PERIInIT Print or Type Only Address City r Describe Proposed Work �r ni ��`�!7�1��v "l�"�-m�,��7— Project Address (if known) PUCIiC Works Pr.rmp t .. ��—P f (,'s BItlB� DepL ♦ Pu011c Works Foo To�e� F�o s less Appl Fee ^altl $ BalancoDua $ Attach tour (4) copies oF plans for proposed work • Draw to scale and note the (ollowing as applicalile: � Property Lines • Centerline of streel • Outline and dimen; ions of all existing and • Indicate Norlh proposed struclures� on the iot • Show any proposed grading changes •[zistirva and proposed uUli'ies • Show measurements Phone PEFMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance - phone 259•881 5. 2. All work shall be performed in accordance with this permit and current City of Everett Design and Conetruction Standards and Specilicatlons 3. Call Location Underground Service 4B hrs. betore you dig. TOLL FREE NUMBER 1•800•A24•5555. �Jo� .:��E'a, fo,e TE.✓.9.�/r .7Hr� Approved for Construction Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98207 Phone: 259•8815 s/„��,T .✓ ACKNOWLEDGEMENT OF CONDITIONS W � � � � � � 0 � The undersigned owner/applicant hereby agrees to hold and save harm- Iess the City of Everett from any and all claims ior damages, costs, expenses, or causes of action lhat may arise because of installation and maintenance of the improvement or olher right-of•way use hereto applied for and further agrees to remove same upon notice from the City and to repl2ce public property damage� thereby. Signature of Applicant Date WORK AUTNORIZED BY THIS PERMIT MUST �E STARTED -NITHIN 180 DAYS OF DATE PERMIT IS I5SUED AND THEREAFTEfi IS TO BE DILIGENTLY PURSUED TO COMPLETIOtJ. T�i:S PERMIT MA'� BE CANCELLED BY THE CITY UPON ANY STOPPAGE UF WORK ON THIS PROJECT OVER 90 DAYS DURATION.