4112 GRAND AVE 2018-01-02 MF Import

Date-12-3=32 Application For PUBLIC WORKS PERMIT Print or Type Only 5 "^ POSTING 7-4 3 i v�mm won. v.,mn . eav oed� . 38959 'Wi: W.n.F.. f T..i Fee — u...vm Rodney 6 Jeanette Bigelow PO Box 1354 Stanwood WA 98292 Owner Mailing Address City Zip Phone Owner Applicant Mailing Atltliess City Describe Proposed Work new Project Address (it known) Attach lour (4) copies of plans for proposed work - Draw to scale and note the following as applicable. • Properly Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed ulilities • Show measurements PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance - phone 259-MI0. 2. All work shall be performed 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. 300-424.5555. q, 15g, Jewtivey mtwit pupert y lute Jnd eJcr nC CWM4Fl1-t hl rMy, 1% ACKNOWLEDGEMENT OF CONDITIONS Approved ns Constructed AID= PUBLIC 3200C WORKS DEPARTMENT 3200 Cedar Street VJWM Everett WA 98201 Phone: 259-8810 Z O The undersigned owner/applicant hereby agrees IO hold and save harm. less the City of Everett from any and all claim; 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 lurlher agrees to remove same upon notice from the City and to replace Public property damaged thereby. ✓��1 Signature of Applicafil Data 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.