2602 HILLSIDE LN 2016-01-01 MF Import

Date � '� C.� � Application For PUBLIC WORKS PERMIT Print or Type Only ng Mailing Describe Proposed Work Project Address (if known) �-� Public Works Permil • �� _ BIOg. Dep1. • Puolic works Fee s To�al Fee laSs Appl. Fee PaiO S Belance Due s (%1�`}' �t'1��i�t/.,� '1ir7 ��.� City Zip Phone Cily Zip Phone Attach four (4) copies ot plans for proposed work • Draw to scale and note the following as applicable: • Property Lines • Outline and dimensions of all existing and proposed structures on the lot • Existing and proposed utilities • Centerline of street • Indicate Norih • Show any proposed grading changes • Show measurements PERMIT CONDITIONS 1. A�I calls for inspection shall be made 24 hrs. in advanc� • phone 259•881 5. 2. All work shall be pertornied in accordance with this permit and current City of Everett Design 2nd Construction Standards and Specifications. 3. Call Locetion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-SOO•424-5555. �!/�L.il GtJC,��.rS /��,t"�?iT il/O%�'��L//.(:c/_� lor Construction FINAL INSPECTION Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone:259-8815 fJ'-v'1!: -��i � �� ACKNOWLEDGEMENT OF CONUITIONS W H � � � O � � O a The ur�dersigned owner/applicant hereby agrees to hold and save harm• less the City of Everett Fror� any and a�l claims for damages, costs, expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right�ol�way use hereto applied for and (urther agrees to remove same upon notice Irom the Date City and to replace public property damaged ihereby. Date Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE D�LIGENTLY PURSUED TO COMPLFTION. ThiIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATiON.