1903 HOLLOW DALE PL 2018-01-02 MF Import

Application For Date / d` Z � -/ % PUBLIC WORKS PERMIT PUBLIC WORKS DEPARTMENT Pudic Works Permit If 3200 Cedar Street / Everett, WA 98201 259-8810 Building Permit M zCj '''' TYPE OR PRINT ONLY Public Works Fee $ .'�Q � W.� tot NV I (OI'S 1 �4.� r. S 'r=- S K9h.ati.�a �. t,,�} gk2c-3 er Mailing Address City Zip Phone 4 ( VLI /.t`V- Hoc. S-c. f��la�.'�� L'A I " �/ar 397-o714 T Applicant Mailing Address city Zip Phone Describe Proposed Work LU $ �►�2(/ r',v fin/ PROJECT ADDRESS (if known) Attach four (4) copies of plans for proposed work - Draw to scale and note t following it applicable: 'Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities O 'Centerline of street 'Indicate North 'Show any proposed grading changes 'Show measurements PERMIT CONDITIONS: Z 1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. O 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call L nderground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-55W. /C'V C7d/ea— `c l�-g7 O OZ'hF <90 !Md S0EL6 It a Wd9b:ZT 46-FO-OT ved for C,� fs�t lion"pMe FINAL INSPECTION Date Approved as Constructed ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harmless the City of Everett from any and all claims for damages, costs, expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. /OL#"—l / Signature of App icant Date WORK AUTHORIZED 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. W