2305 HIGHLAND AVE 2016-01-01 MF Import

Date.�(�.�/ �!y � � � Application For PUBLIC WORKS PERMIT Print or Type Only Sa►n T?de Describe Proposed Work NPW /�hAN1f� Project Address (if known) � � Zip PubLc Worka Parmit • � � �'� � eies oeci.. 6-�-- P��I¢ Wprhs Fee TotalFea 8 _ Lesa Ap01. Fee Ppitl S Baiance Oue f . � Zip Phone Attach four (4) copies of plans for propose� work - Draw to scale antl note the fotlowing as applicable: • P�operty Linea • Outline and dimensio�s of all existing and proposetl structures on the lot • Ezisting antl proposed utilities � Centedine of street • Indicate North � Show any proposed grading chenges • Show measuremenis PERMIT CONDITIONS 1. All calle for inspectlon ahall be made 24 hrs. in aAvance - phone 259-8810. 2. All work ahall be pertormed in accordence with thia pe�mit and current Ciry of Everett Design and Construction Standards end Specilk.etlona 3. Call Location Underqround Service 48 hrs. before you dig. TOLL FIiEE NUMBER 1-800-4245555. j � ��2�� .., ��/�� � Approved lor Conshucti n Date I FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everelt, WA 98201 Phone: 25&8810 ACKNOWLEDGEMENT OF CONDITIONS W F- � Z O� F- � O a The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damegea 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 lor and further agrees to remove same upon notice from Ihe City and<L�ace ublic ProPertY damaged thereby. Sign: lure 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 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.