2508 GRAND AVE 2016-01-01 MF Import

C Application For PUBLIC WORKS PERMIIT Print or Type Only Mawng Describe Proposed Work ProjectAddresaptknown) _ Z-S�S� Granol �IvQ 1/, `� PUCI¢ Worka Permit • I BIEpDeo�-��/�9372 P�Elic WorFe Fee Tolal Fee s __ Less AOGI Fee P�IE S Beience Due i 2iP Phone Attech four �4) copiea of plans for proposed work • Draw to scale and note the followir �% ,! a • PropertyLinea • Centedir �/ ar( Q0.� N� ��'Z)�, • Outline end dimensions of all existing antl • Indicate propoaed structures on the lot • Show an • Ezistlnp and proposed utitities • Show me � Lw1i.P�C.�" 2-{ (t/� DO NOT WRITE BELOW THIS LIN g=1� �- � SIDC O PERMITCONDITIONS �yaJ�� l_p� i. All cells Ior Inapection shall be mede 24 hrs. in advance - phone 259-88 i� y� 2. All work ehall be performed in accordance with thie permit and curtent Cit 3tandarda end Specificadons. 3. Call Lacation Underground Service 48 hrs. before you dig. TOLL FREE N /��c wo,P.rs .��il.h,r �.�cv,o�r�y ,ss�� fJ•d0 S/GN�D OAr fcvl Tj�6t �,P�TE.'T. Approved �or Construction Date FINAL INS?ECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Jetler Sireet Everetl, WA 98201 P�ona�259-8810 ':�!"'.- _ � 8 $ ACKNOWLEDGEMENT OF CONDiTIONS W � � � O a The undersigned owner/applicant hereby agrees to hold and save harm• less the City of Everett from any and all cleims for damage& costs, expenses. or causes of action that may arise because of installation and maintenance of Ihe improvement or other right•of•way use hereto app�ied for and further agrees to remove same upon notice from the City and to replace public properry damaged thereby. ��.u�/J 7r�-� /�P�f�" 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 MAV BE CANCELLED BY THE CITY UP6N ANY STOPPAGE OF WURK ON THIS PROJECT OVER g0 DAVS DUHATION.