6530 HIGHLAND DR 2016-01-01 MF Import

Date�� Application For PUBLIC WORKS PERMIT Print or Type Only Public Worke Perm� Blap. Oept. • PuEi�c Wprkn Fee Tolel Fee S Less Appl Fee PaiE S Balence Oue i Phone Applicant Mailing Adtlress City Zip Phone Describe Proposed Work Prolect Adtlress (il known) Attach lour (4) copies of plans for proposed work • Oraw to • Property Lines • Outline and dimensions af ell existing and proposed structures on the lot • Existing and proposed utilities nole the following as applicable: • Centerline ot street • Indicate North • Show any proposed grading rhanges • Show measurements PERMIT CONDITIONS 1. All cslle for Inspection ahell be made 24 hrs in advence - phone 259�8814. 2. All work ehall be pertormed in accordance with this permit and current City of Everett Design and Constructlon Standarda and Speclfications. 3. Call Location Underground Service 48 hrs, bafore you dig. TOLI FREE NUMBER 1$00-424•5555. �� .�� �J� � n,� g ,�-88 lor Construction Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPFRTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259•8810 ACKNOWLEDGEMENT OF CONDITIONS W H � � � 0 a The undersigned owner/applicant hereby agrees to hold and save herm- less the City of Everett irom any and all claims lor dameges, costs. expenses, or causes of action that may arise because of installation and maintenance of the improvement or other righl-of•way use hereto applied for and further agrees to remove same upon notice irom the City and to rep�ace public property damaged thereby. Signature of Applicant Date WORK AUTHORIZED 8Y THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PEFDAIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE CANCELLED BY THE CITY UPOY ANY STOPPAGE OF WORK ON THIS PRO.IECT OVER 90 DAYE D'Jr7ATION.