7420 LOWER RIDGE RD 2016-01-01 MF Import

Date %�—� Application For PUBLIC WORI(S PERMIT Print or Type Only Describe Proposed Work Project Address lif known) � ;�'oX � �G � Maifing Address City Mailing Address City � �2J% ip Pu�lm Works Permit ♦ � `�� Bloil� Deot + Pu�lic Worka Fee S � f Total fea Less 4ppL Fae Pni� $ —� Balanco Cuc $ Phone cip �•none Atlach four (4) copies ot plans tur proposed work - Draw to scale and note the followins as applicable: • Pruperty Lines • CeMerline of street • Outline and dimensions of all existing antl O Indica�e North proposed structures on the lo� • Show any proposed grading changes • Existing and proposed u�ilities � • Show measuremenis LI PERMIT CONDITIONS 1. All calls for in;peclion shall be made 24 hrs. in advance � phone 259-881 5. 2. All wor4 shall be pertormed in accordance with ihis permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Localion Underground Service 48 hrs. before you dig. TOLL FREE NUMBEH 1-800-424•5555. Q/ n /r/ n o r ..e art� /l�ov'eln e/� � �' �O ��l � J S.� � �a�% .s . /o �� t FINAL INSPECTION I 1 � qpproved as Const�ucted �� everett PUBLIC bVORKS DEPARTMENT � 3200 Cedar Slreet Everett, WA 90201 Phone: 253-88 7 5 Date Date �Ych��- C/ Yc2' � ri a�J—e.• ,SGtJcc /� i ACKNOWLEDGEMENT OF CONDITIONS W H � � O � � � a The undereiqned owner/applicant hereby agrees to hold and save harm- less lhe Ciry of Everett from any and all claims for damages, cos�s, expenser. or causes of action ihat may arise because of installation and mainlenance of the improvement or other right-of-way use hereto applied for and further agrees lo remove same upon notice Irom the City and to ' lace public property damaged ihereby. _ � ^ / ignature uf Applicanl Date WOHK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEH IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCE�LED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.