3310 HILL AVE 2016-01-01 MF Import

Date.�•� Appiication For PUBLIC WORKS PERMIT _: _., , Print or Type Only Mailing Address � Pu�Lc Works Permn + BItlp.Oept.+ � li Publicl9o�kaPee S lotal Fee Less AOD� Fee Paitl S Belence Uue S � Phone Describe Proposed Work �� --� �A I � 1� i� �_� Y�r,��S� �� 4 )l�i� Project Address (if known) Attach four (4) copies of plans for proposed work • Draw to scale and note the following as applicable: • Property Lines • Centerline of street • Outline :�d dimensions of all ezisting and • Indicate North proposed structures on the lot • Show any proposed grading changes • Ezistlng and proposed utilities • Show measurements PERMIT CONDITIONS 1. All cells tor inspection shall be made 24 hrs in advance • phone 259•8615. 2. All work shall be pertormed in accordance with Ihis permit and current City of Everett Design and Construction Standards and Specifications 3. Cell Locatian Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. ,�-�'F.��r �o� :� i�-F�9 �//.�'G/C Cc�o/'.FS -f� �7u��,n �� . �A� r Approved for Construction Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 ACKNOWLEDGEMENT OF CONDITIONS W H � M �� � � O � � O a The undersigned owner/applicant hereby agrees to hold end save harm• less the City of Everet; from any and all claims for damages, costs, expenses, or cau�a^ of action that may arise because of installetion and maintenance of the improvement or olher right-of•way use hereto applied for and further agrees to remove seme upon notice from tha City and to replace public property demaged thereby. Signature of Applicant Date WORK AUTHOflIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.