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Applical:on For Date / / _ • / <br />OL PUBLIC WORKS PERMIT <br />Public Works Permit # L <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Stroet �/Th�3 bw.ildry <br />Everett,WA98201 (425)257.8810 Building Permit# 47960T} r��tl(fj <br />TYPE OR PRINT ONLY Public Works Fee $ <br />City of Everett 3002 Wetmore Avenue Everett 98201 <br />Owner <br />Mailing Address City Zip Phone <br />Parks Department Ryan Sass 257-8300 (E,.t 3002) <br />Applicant Mailing Address City Zip Phone <br />Df-scribe Proposed Work Rotary Park, Phase IB, parking area pLving W <br />M/ <br />PROJECT ADDRESS (if known) 3505 Lowell/Snohomish River Road Im <br />Attach four (4) copies plans for proposed work - Jraw to scale and note the following if applicable: <br />• Property Lines • Outline and dimensions of all existing and proposed structures 0.1 the lot • Existing and proposed utilities <br />• Centerline of street • Indicate North • Show any proposed grading changes • Show measurements <br />DO NOT WRITE BELOW THIS LINE Z <br />PERuj! CONDITIONS: O <br />1. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications.. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. ♦/► <br />4. Work to be done per approved plans dated 4-12-99.rev ahae'Xed) O <br />7T a <br />FINAL INSPECTION <br />Approved as Constructed <br />? Z <br />Date <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmless <br />the City of from any and all claims for damages, costs, expenses, or <br />causes action t t may arise because of installation and maintenance of the <br />imprev ant o ther right-of-way use hereto applied for and further agrees to <br />remoy sa notice'rom the City and to replace public property dam - <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANLELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRO ECT OVER 90 DAYS DURATION. <br />