2815 HIGHLAND AVE 2016-01-01 MF Import

Date Application For PUBLIC WORKS PERMIT Print or Type Only 3/bz MaiNng Deacribe Propoaed Project Atldress (if known) 93 PuEIm Worha Permit • v �`�' �/ BiaO Oeo�� • P��I¢ Works Fee = Totn� Fee less AOP�� Fee PeiE S _ 7. ! eaia��e o�� s �� Attech four (4) copiea ol plana lor proposed work • Draw to scale and note the following as appliceble: • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Exfstinq and propoaed utilities • Show measurements rnone Phone PERMIT CONDITIONS 7. All calls for in�pectlon ahall be made 24 hrs. in edvance • phone 259•8810. 2. All wodc ehsll be peAormed in eccordance with this permit and current City cl Everetl Design and C��istructlon Shnduds and Specifkstlons. 3. C�II Locatlon Underpround Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800�424•5555. ,j�� .�� r v`,./d� �icS p�i �L 8 � Z � - �3f3 Approved as Constructed everett PUBIIC WORKS DEPARTMENT � 3200 Ceder Slreet Everet4 WA 98201 Phane:259-8810 N� y- 5�73s� 3.7G -39of' � ACKNOWLEDGEMENT OF CONDITIONS W H � � � O � � O a The undersigned owner/applicant hereby agrees to hold and save harm• , less the City of Everett from any a�d 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 lor and further agrees to remove same upon notice from the City and to replace public property damagzd thereby. � ,��iD� `1�� Signatur�Applicant � WORK AUTHOFIZED BY THIS PERMIT MUST BE STARTED WITHIN lE0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTIY PURSUED TO COMPLETION. THIS PERMIT MAV BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.