720 MADISON ST 2016-01-01 MF Import

Date ��-�-94 Application For PUBLIC WORKS PERMIT Print or Type Only Pubi¢ WorMs Pernn a Biae. oeo�� • _.la� Public Works Fea To�al Fee $ Less ApO� Fee PaiE $ Balance D�e $ Arthur Carrick 720 Madison St Everett 98203 353-4624 Owner Mailing Address City Zip Phone Owner Applicant MiilingAddress City Zip Phone Describe Proposed'JJork new Project Address (if known) 720 Madison St Attach four (4) copies of plans for proposed work - Draw to scale and note Ihe following as applicable: � • Property Lines • Outline and dimensions of all existing and proposed structures on the lot • Existing and proposed utilities • Centerline ot street • Indicale North • Show any proposed grading changes • Show measurements PERMIT COND�TIONS 1. All calls for inspection shall be made 24 hrs. in advance - phone 259-8810. 2. All work shall be pertormed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. FUBLIC WORKS PEBMIT hOT REOUIRED 9Y_� s1ATE � �'j �� :..�� Approved for Construction Date FINAL INSPECTION Approved as Constructed PUBLIC WORKS DEPARTMENT 3200 Cedar Slreet Everett, WA 98201 Phone:259•8810 Dale ACKNOWLEDGEMENT OF CONDITIONS W � � � O ■ w _ / O a The undersigned owner/applicant hereby agrees to hold and save harm- less �he City of Everett Irom any and all claims for damages, cosls, expenses, or causes of action that may arise because of installation and main�enance of lhe improvement or o�her right-of�viay use herelo applied for and further agrees to remove same upon notice from the City and to replace public property dama9ed thereby. Signature of Applicant Date 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 CANCELLE.D BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.