2001 E GRAND AVE 2016-01-01 MF Import

, Application For �' �/w�y � PUBLIC WORKS PERMIT Date �+ i PUBUC WORKS DEPARTMENT Public Works Permit N � 3200 Cedar Stre�tt Everett,WA 9B201 259-B810 Bullding Permit 8 �n ��JSTING �UN 1 5 1998 p� TYPE OR PRINT ONLY Public Wciks Fc:e S��C7"r �t�r-l�tyic�v�1� 1- 1 .��lve�G '�—�i'�65 Owner Mailing.address City Zip Phone Applicant PAailing Address City Zip Phone Describe Proposed Work �t"7� ��_[CJ _� � /�'�A;� _. � _ � � PROJECT ADDRESS(if known) l�C�c.(J � �• � � � � Attach lour(4)copies of plans for proposed work-Draw to scale and note ihe following if applicable: � •Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities O '.:enterline of stmet •Indicale North •ShoH�any proposed grading changes •Show measurements DO NOT WRITE BELOW THIS LINE �k'k PERMIT CONDITIONS: / Z 1. All calls for inspection shall be made 24 hours in advance- phone 259-8810. �7155 2. All work shall be pertormed in accordance with this pertnit and current City of��De�P� O Construction Standards and Specifications. �; �3qg 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUM� 1-800-424-�. � �. AS �er ��✓ov�ed �l�h d�� 5121�q�. V� � a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold antl save harmless `re� the CiTy of Everett from any and all claims tor damages,costs,expanses,or causes of action that may arise because of installation and maintenance of p ved or ction � ate theimprovementorotherright-of•wayusehe2toappliedtorandfurtheragrees � to remove same upon notice from the City and to replace public property ,1�- �_�� damagedthereby. FINAL INSPECTIO Date Approved as ConsWcted �� Sig plicant Da e WORK AUTHORIZED 8Y THIS PERMIT MUST BE STARTED WITHIN 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PR0.)ECT OVER 90 DAYS DURATION.