505 SE EVERETT MALL WAY STYLE SETTERS 2016-01-01 MF Import

Date �� ( Applicalion Fot PUBLIC 111/ORKS PERMIT Print or Type Only nnamnq nddress Describe Proposed Work Project Address (if known) ary � ♦ Attach four (4) copies of plans for proposed work • Draw to scale and note the follovving as applicable: • ProFerty Lines i Outline and dimensions of all existing and . proposed structures on ihe bt • Existing anC proposed utilities PUEIie Works Pbrmit r��r _ 61Cg. Depl. e .� Puplic Works Fee Tolal Fae $ Lesa AcpL Feo Paia $ ealanca0ue S • Centerline of street • Indicate North • Show any proposed grading changes • Show measuremenis Phone FEFMITCONDITIONS 1. A�I ca:ls for in;pection shall be made 24 hrs. in advance • phone 259•8810. 2. P.II work shall be performed in accordance with this permit and current City of Everett Design and Consiructiun �'aidards and Specification�. 3. Cali Location Underground Service 49 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. l�l�S( �I T�� / � 5��8 Approved lor Construction Date FINAL INSPECTION AUProved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Streel Everett, N1A 98201 Phone: 259-8870 Date �,b. �.. i'Y. � r.,: �:� �. ACKNOWLEDGEMENT OF CONDITIONS W H � � 0 � � O a The undersi3ned owner/applicant hereby agrees to hold and save harm• less the Cily of Everett Irom any and all claims for damages, costs, expenses, or causes of action that may arise because of inslallation and maintenance of the improvement or other right-ol-way use hereto applied lor and furiher agrees to remove same upon notice trom the City and to replace public property damaged thereby. Signature of Applicant Date WORK AUTHORIZ�D 8Y THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREl�FTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY LIPON ANY STOPPAGE OF WORK ON THIS PRUJECT OVER 90 DAYS DURATION.