1322 GRAND AVE 2018-01-02 MF Import

Date�$� C ( PuElie Warke Parmil• Applice�ion For BItlO�Depl.• PUBLIC WORKS PERMIT PUDTotelFeeFee = Leae Appl fee Paltl t Print or Type Unly Ba�a�=ao�e t � N� v �" �n�1 i � ��a�� ,d�� F��2,�- 9 2n1 �R-�9a Owner Mailing Address City 2ip Phone ` �m� Applicent Mailing Address City Zip Phone � Dsecribe Proposed Wark f'C1�1 J�� + �C� � Prolect Address(if known) � � Attach four(4)copies of plans lor proposed work• Draw to scale and note the Iollowing as applicable: � • Property Lines , • Centerlina of street � • Outline and dimenalons of all existing and • Indicate North propose0 structures on the lot � Show any proposed grading changes • Exieting and proposed utilities • Show measuraments � DO NOT WRITE BELOW THIS LINE PEqM1T CONDITIONS O 1. All celis for Inapection ahall be made 24 hrs in advance•phone 259•8815. � 2. All work shall be pertormed in accordence with this permit and current City of Everett Design and Construction Standarda and Specifications 3. Call Location Underground Service 48 hrs before you dig.TOLL FREE NUMBER 1•800-424•5555. � P�� o,�- �E.�„- ,��-,�cGJU/,f'EO y,� g� O � : � O a ACKNOWLEDGEMENT OF CONDITIONS The underaigned owner/applfcant hareby agrees to hold and eave herm- less the City of Everett from any and all cleims for demape4 costs, expense�, or causes of action that may arlae beceuse of Installatlon er.d maintenence of the improvement or other right•of•way uae heroto Approved f�r Conatruction applied for and further agrees to remove same upon notice from the Dete City and to replace public property tlemeged thereby. FINAL INSPECTION Date Approved u Constructed Signature ot Applicant Dete everett PUBLIC WORKS DEPARTMENT WORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN � 3200CedarStreet 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAF7ER IS TO Everett,WA 98201 BE DILIGENTLV PURSUED TO COMPLETION.THIS PERMIT MAY BE Phone:259�88� CANCELI.ED BY THE CI7Y UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.