505 SE EVERETT MALL WAY KIDS MART 2016-01-01 MF Import

Date � JX$�' � Applicalion For PUBLIC WORK� PERMI"f Print or Type Only � Describe Proposed Work Project Address (if known) Mailing ( PUDIm Works PermCl!3+ BICO� Dept. M __Lu�_ Publit Works Fee Totel Fea S less AOG� Fee PaiO $ Balance Due $ Attach four (4) copies of plans for proposed work • Draw to scale and note the following as applicable: • Property Lines • Centerline o� street • Outline and dimensions of all existing and O Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and propoaed utilities v Show measurements PERMITCGNDiTIONS 1. All calls for incpection shall he made 24 hrs. in advance • phone 259•8810. 2. All work shaq be performed in accordance with this permit and cun�ent City of Everett Design an[' Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL PREE NUMBER 1-800•42� Approvr;d for Construction Date FINAL INSPFCTION Approved as Constructed evere[[ PUBLiC WORKS DEPARTMENT � 3200 Cedar Street Everet6 WA 98201 Phone: 259-8870 Date rnone vction �� //� �� ACKNOWLEDGEMENT OF CONDITIONS W h � ■ � O a The undersigned owner/applicant hereby agrees to hold and save harm� less ihe City of Everel� irom any and all claims for damages, costs, experses, or car�=s ot action that may arise because of installalion and maintenanct �f the improvement or other righbof�way use hereto applied tor and further agrees to remove same upon notice irom the Ciry and to replace public pruperty dam�ged thereby. Signature of Applicant Cale WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK OIJ THIS PROJECT OVER 90 DAYS DURATION.