2814 LARLIN DR 2016-01-01 MF Import

Dale�� Appliiation For PUBLIC VI/Oih'KS PERlVIIT Print or Type Only Appli�ant Descrihe Proposed Work Project Address (il known) Mailing Address Ma Ci�y Adach four (4) copies ot plans lor proposed work - Draw to scale ana no�e ihe lollowing as applicable: • Property Lines • Outline and dimensions ot all eR: �ting and proposed strectures on �he lot • Existing and proposed ulilities a„ni�c wo�ks ao�m�i . - Biee �eot. s � /G � PUULCWorxsFe.o 5 Total Fec Le55AppL Poe Paid S BaIOncC Oue b • Centerline ol stree� • Indicate North • Show any proposed 9rading changes • Show measurements IIC Phone Phone PERMIT CONDITIONS 1. All calls tor inspection shall be made 24 hrs. in advance � phone 259•88� 5. 2. All work shall be performed in accurdance with ihis permit 3nd curreM City of Everelt Design and Construction Standards and Specifications. 3. Call Lowtiun Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•F30^.•424-5555. �' �GrsCiL' A�proved for �'�.�.-�-5 �cr/�ii FIIJAL INSPECTION Approved as Consiructed eveiett FIIBLIC'NORKS DEPARTMENT � 3200 CedarStrec:t Everett. WA 98201 Phone�.259�6615 ,�o: .E'�c��.2F.b �-23 '� ��. � ACKNOWLEDGEMENT OF COKDITIOKS Z O ♦1'�� �♦ ��q W Thr. undersigned owner/apphcant hereby a,rees to hold and save harm- less Ihe Ciry of Everett from any and all cla�ms lor damages, costs, expenses, or causes of adion that may arise because o! installation and maintenance ot the imnrovemenl or other ric�ht-ol�way use hereto applied �or and luriher agrees tc remove same upon notice Irom the Date Ciry and to replace public proFerty damaged ihereby. Date pa��, Signature of ApplicaM WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO 8E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF NJORK ON THIS PROJECT OVER 90 DAYS DURATION.