6514 HIGHLAND DR 2016-01-01 MF Import

Lat9�] � �-c�� ,-� Appllcation For PUBLIC WORKS PERMIT Print or Type Only P�eu� woa. v.,mn . e�.q orot • Pubik Works Fw Tot�i Fsa S Lau Appl Fw P�IA s B�I�nce Ow Applic�nt Melling Address C�y Zip P�one � Ds�cMbe Propoaed Work &,�� ProJect Addross pl known) Att�ch four (4) coplea ol plena for p�opoaed wo/k �rew ta scale end note the following as applicable: • Property Linee .� Centerline ot street • Outlins end dimenalons ol all eziating end • Indicate North propoesd etructures on the lot • Show any proposed grading chanpea • Exletlnq end propoaed utllitles • Show measurementa PERMIT CONDITIONS 1. All calls tor Inepection ahall be made 24 hra in edvance - phone 259•8815. 2. All work ahall be pertormed in accordance with this permit and curcent City of Everett Dealgn and Conshuction Standercle �nd Speclflcationa 3. Call Location Unde�ground Service 48 hrs before you dig. TOLL FREE NUMBER 1•800�424•Sasb. �v��,� �,�-.s ��„ ,rlo�- �P�v,,�o f'-ir- 8 � C�� Approved for Construction Date FINAL INSPECTION Date Approved as Consiructed everen PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259•8815 ACKNOWLEDGEMENT OF CONDITIONS W H � � The undersigned owner/applicant hereby aprees to hold and aeve herm- less the City of Everett irom eny and all claima lor Aamaqes, costs, expenses, or causes of action that mey eriae because o( Insteltation and maintenance of the improvement or other Hghbof-way uae hereto applied for and turther agrees to remove aame upon notice (rom the City a�d to replece pu lic property dameyed thereby. ' -c� /�3 /� - Signa ure of Applica t Date WORK AUTHORIZED EY THIS PERMIT MUST BE STARTED WITHIN iB0 DAYS OF DATE PERMIT IS ISSUED ANO THEREAFTER IS TO BE DlLIGENT'. Y PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WOiiK ON THIS PROJECT OVER 90 DAYS DURATION.