801 LAUREL DR 2018-01-02 MF Import

t01 Uate �1.97 Application For PUBLIC WORKS PERMIT Print or Type Only �A Owner Applicant Mailing Address Mailing Describe Proposed Work lily Zip Public Works Permit • ----� Bldg. Dept. s Public Works Fee il. n Total Fee $ 2-0 Less AppL Fee Paid $ �_ Balance Duo $ 7 - Project Address (if known) CQ(^' W� ,l!w.,n-�� UJ 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 DO NOT WRITE BELOW THI .lNE PERMIT CONDITIONS O 1. All calls for inspection shall be made 24 hrs. in advance - phone 259-881 5. 2. All work shall be performed in accordance with this pormit and current City of Everett Design and Construction Standards and Specifications. a t3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBERR�1-800.424.5555. .7 /)17,? ✓1 �Cu a" S / q�l J4 /S��i i� J /�t�✓ Ci • Sre�¢. nd 6,e on a ;�te L_ qe/ C kct r Z r 02/20/97 5,33P11 000441 is 000089608 as DPT,20 $20.00 ACKNOWLED&WfgNT OFbRM4911fIONS I FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 Phone: 259.8815 1 The undersigned cwner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, costs, expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant Da WORK AUTHORIZED BY THIS PER IT MU BE STARTED WITHIN 180 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.