5709 HIGHWAY PL 2016-01-01 MF Import

Date��'/S "B� Application For PUBLIC WORKS PERMIT Print or Type Only Describe P�oposed Work Prolact Addrass (il known) Pu01¢ Wods Pormil � � eiea. neo�� Public Wo�ks Fee S �h� �— Total Fee Less AOP� Foe PaiE S Ba�ance Oue $ �3� .c..A� %`�/7 �,eESEivI Mailing Address City Mailing Address City Zip C6�/ � I iLt �l,P� /�.ii��'�/ Attech four (4) copies of piens lor proposed'work • Draw to scale and • Property Lines • Outline end dimensiona of all ezisting and proposed structures on tlie lot • Exlsling end proposed utilities the following us applicabie: • Centeriine of street • Indicete North • Show any proposed grading changes • Show measuremenls PERMIT CONDITIONS 1. All calls tor inspectlon sheli be made 24 hra in advance • phone 259•881 5. 2. All work ahell be performed in accordance witY this permit and current City of Everett Design and Construction Standerds and Specifications. 3. Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424•5555. /• �`-h� �%A�-'-P�" /��Cl/'!T� �/�� ,/U-�S-'�/ / v ��'y��/ FIN ' PECTION � Approved as Constructed everett PIIBLIC WORKS DEPARTMENT � 3200 Cedar Streel Everett, WA 5� ��'11 Phone: 259•8815 -d. Date ACKNOWLEDGEMENT OF COtJDITIONS The undersic�ned owner/applicant hereby agrees to hold and save harm- less the City of Everett fro any and all claims tor damages, costs, expenses, or causes ol actio that may arise because of instellation and maintenance of the impr vement or other right-of-way use hereto applied for d furiheJ � agree to remove same upon notice trom Ihe City and eplace p�1G,lic pro erry damaged thereby. 1� /%/� �. . . / _ ig �ure ol A�'pliCent `1 � ua�e. RK AUTHORIZED BY THIS PERMIT MUST BE STAR ED WITHIN 80 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER �S TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PER!1IT MAY BE CANCELLED BY THE C�TY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.