7029 LOWER RIDGE RD 2018-01-02 MF Import

Date ia7 �5--J�� Application For PUBLIC WORKS PERMIT Print or Type Only aee,unn Addrasa � Cd Public worse Permit • Bldg. Dept. Public wort Fee S 1_ 5 -� Total Fee Less Fee Paid S Balanceclt o Due S Zip Phone ✓i Iw Phone Applicant Malling Address City ZIP 2 G'6 Describe Proposed Work ✓ '�"" - - - t� Project Address (if known) Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hr& in advance - phone 259.881 5. 2. All wol k shall be performed in act:ordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 his. before you dig. TOLL FREE NUMBER 1.800-424-5555. FIrIAL INSPECTION Approved as Constructed everett PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 Dale Date ACKNOWLEDGEMENT OF CONDITIONS No The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, coats, expenses, or causes of action that may arise because of installation land mainte a of the Improvement or other right-of-way use hereto i applied f an further agrees to remove same upon notice from the City an to r lace publi party damaged thereby. Signature of Applica t Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 160 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 ON THIS PROJECT OVER 90 DAYS DURATION.