2813 LEONARD DR 2018-01-02 MF Import

Date�'�! Application For PUBLIG WORKS PERMIT Print or Type Only Owner Applicant Describe Proposed Work Project Address (if known) ciry City Lip Attach four (4) copies o� plans for proposed work - Draw W scale and note the following as applicable: • Property Lines • Outline and dimensions of all existing and proposed structures on ihe lo� • Existino and proposed utilities NOT PERM1IIT CONDITIONS Pu�Lc \'lo�ks Pcrmil r 2 BIOB.Dept • �.2�_ Pue�ic Wo�Fs Feo Toial Fee S LC55 FOOI FCC Pd�ld S BdItnCC OuC S rnone 3S3 - �`� �� Phone • Cen�erline of street • Indicate NorLi • Show any proposed gradiny changes • Show rneasurements 1. All calls for inspection shall be made 24 hrs. in advance � phone 259•88� 5. 2. All work shall be performed in accordance with this peimit and current Ciry of Everetl Design and ConsVuction Standards and Specifica�ions. 3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800•424•5555. ��=.� ' , -�'- �'�� =x� �G'?��t�'-� rm_ � 'G• 't-, Approved for Conslruction Date FINAL INSPECTION Date Approved as Gonstructed everelt PUBLIC WORKS �EPARTMENT � 3200 Cedar Stree� Everett, WA 98201 Phone:259�8815 j l�—fi/� �� � r- ACKNOWLcDGEt.1ENT OF COIJDITIONS W H � � � The under;ic�ned owner/applicant I:ereby agrees to hold and save harm- less the City ol Everetl Irom any and all claims for damages. costs, expenses, or causes of aciion that may arise because of installation and maintenan;,e of ihe improvament or other ric�iit�of-way use hereto applied for and further agrees to remove same upon notice trom the City and to replace Fublic property damaged �hereby. Signature ol Applicant Date WOFK AUTHORIZED BY THIS PERMIT MUST BE .STARTED IVITHIN 180 DAYS OF DATE PERMIT IS ISSUEJ AND THEREAFTER IS TO Bc DILIGENTLY PURSUED TO COAIPLETION. THIS PERM�' hIAY BE CANC[LLEU BY THE CITY UPON ANY STOPPAGG OF WQ�iK ON TFIIS PROJECT OVER 90 DAYS DURATION.