3820 GRAND AVE 2016-01-01 MF Import

� � TYPE OR PRINT ONLY Describe Propnsed Work Application For PUBLIC WORKS PERMIT PUBLIC WORKS DEPARTMENT 3200 Cedar Sireet Everett, Wq g8201 259-8810 Malling Address PROJECT ADDRESS (f known) 3 g�i — �ry � Date �/G�/��_ , Public Works Pertnit A_ y�Q �z Building Permit 8 Public Works Fee $ � — Attech four (4) copfes of plans }w p1oposed work - D2w to scale and note the following 'rf appllcable: 'Proparty Lines 'OutBne and dimenslons of all ezisting and proposed structures on the lot •F�c(sting and proposed utilities 'Centerline of street 'Indicate NoAh 5how any proposed greding changes •Show measurements PERMIT CONDITIONS: �--- --��--"-- 1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. 2. All work shall be pertormed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. �� t �r zr'��d �/�r /�y �� z�� _ VV„y�� uate � �" `�� % L /�' _ /C� 06/10/96 / HOOO9SG1^c DRIUAN CHEq; 3:39FM t?0.00 fLO.00 ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agreos to hold and save hartnless the City of Everett Irom any and all claims for damages, costs, ezpenses, or causes of action that may anse because ot Insts!lation and maintenance of the improvement or other right-of-way use hereto applied for and fuAher agrees to remove same upon notice from the City and to replace public property damagedthereby. ; � � oign�e oi pIICBfli _� e� �•/0�q6 � Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WIiHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLEfION. hIIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.