2414 HIGHLAND AVE 2016-01-01 MF Import

/ � �, Date� Application For PUBLIC WORKS PERMI7' Print or Type Only � Meiling Address Address Deacribe Propoaetl Work �/1�///��i49r � Pro)ect AdCrees (if known) .-W Publit Warka Per - e aia9. nao� • PUEIICWorknFee s Totel Fee Less AOG� Fee PelO s Belence Due S Atlech (our (4) copies of plena for proposed work • Draw to scale and note the following as applicable: • Property Linea • Centerline ot street • Outline end dimenniona ot ell eziating end • Indicate NoAh proposed etructurea onthelot • Show eny proposed grading cheneos • Ezistinp and propoaed utilitiee • Show measurements PERMIT CONDITIONS Phone t. All calls tor inepectlon she�l be made 24 hra in advence • phone 259•8815. 2. All work ehell be peAormed in accordance with lhis permit and current City of Everett Design end Construction Stend�rcla and Speclflcations 3. Call Location Underpround Service 48 hra belore you dig. TOLL FREE NUMBER 1•800�424•5555. /(/p i'c:r.3� i �' !*/o.C�s� t�E.e�T �Equ�-eE.o r7�•�L/C9,v7 Syou� Cvn�Sr�C% GuiT�! �L!/A�iJ/.�/G /N�ECTo2 !'ONGE/.:/�.t/iAJB .S'i 2B' �' �XT�i.2E Sc,P�'tJ� L/NES, Approved for Conslruction Date FINAL INSPECTION Date App�oved as Constructed F'UBLIC WORKS DEPARTMENT 3200 Ceder Sireet Everett, WA 98201 Phone: 259•8815 ACKNOWLEDGEMENT OF CONDITIONS � O � � O a The undersigned owner/appticant he; eby agrees to hold and seve harm- less the City of Everett from any and all ciaims tor damages, costs, expenses, or causes of action that may arise because of installation and maintenance of the improvement or other righPof•way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signat re of Applicant � /� atD e WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PEFMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.