6830 HIGHLAND DR 2016-01-01 MF Import

Date�� , . Applicedon For PUBLIC WORKS PERMIT Print or Type Only Owner City ' Zip PuClic Works Parmit � �G� ama. oeo�� • Pu0licWo�k�Fee 23�8 Totsl Fee S Uu Appt Fee P�itl f n. � Bel�nce Oue S Phone S 3w�� Applicant Mailing Address City 2ip Phone Deacribe Proposetl Work n°�IM�I �SC��i� 1 SG�I �i a Gy11�rGy� �ONAP�:� Pro�ect Address lif known) Attech laur (4) copies ol plans for proposed work • Draw to scale and note the tollowing as applicable: • Property Lines • Outline end dimensions of all existing and p, �posed structures on the lot • Existina and proposed utilities FINAL INSPI Approved as everett e PERMIT CONDITIONS • Centerline ot street • Indicate North • Show eny proposed grading changes • Show measurements 1. All cells for inspection shall be made 24 hra in advance - phone 259•881 5. 2. All work shell be pertormed in accordance with this permit and current City of Everett Design and Consiruction Stendards and Specifications. 3. Cell Locetion Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800-424•5555. �, %,�v,r a�� ran.d /��-S / PUBLIC WOR�KS DEPARTMENT 3200 Cedar Street Evere��, WA 98207 Phone: 259�8815 �ate 2 � �g � Date ACKNOWLEDGEMENT OF CON�ITIONS W F- � � O �� r•, �' � The undersigned owner/applicant hereby agrees to hold and save harm� less the City of Everetl irom any and all cleims lor damages, costs, ezpenses, or causes of aclion lhat may arise because of installation and mainlenance of the improvement or other right-of•way use herelo applied lor and further agrees to remove same upon notice Irom the City and to replace public property damaged thereby. �� $ 3 Sig ture of ApGlicant Dale WORK AUTHORIZED BY THIS ERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO 8E DILIGENTLY PURSUED TO COMPLETION. THIS PERMII' MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK OI. THIS PROJECT OVER 90 DAYS DURATION.