7827 GRANT DR 2016-01-01 MF Import

Date � -�� "�� Application For PUBLIC WORKS PERMIT Print or Type Only c ng Applicent DBSCribe PrOpOSed Work n�� - Pro�ect Address (if known) P�ibM1c IVo�Fs Pt rmd � _ �� /� � ome. o�n�. , � �� PubLc WmkS Feo g Talal Fee Less A00� Fee PaiE g 7 �� Bnlence Due $ �� City Zip Phone ary [ip rnone Attach four (4) copies of plans fm proposed work - Draw to scale and note the following as applicable: i Property Lines .• Centerline ol street • Outline end dimensions of all exis�ing and • Indicate Norih proposed structures on the lot • Show any pioposed grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance • phone 259•881 5. 2. All work shell be performed in accordance with Ihis permit aod current City of Everett Design and Goasvoction Standerds and Specilications. 3. Call Location Under�round Service 48 hrs. belore you dig. 70LL FREE NUMBER 1•800•424-S;i5S. y ;—� Tr_'A ��c �= 4�C/i/'ES� �;V<�i7�o/�/�G /c= c�iT�(: Approved Approved as Conslructed \ I X v v everctt PUBLIC `NORKS DEPARTMENT � 3200 Cedar Street Evcrett, WA 98201 Phone: 259�0815 /� Date ACKNOWLEDGEMENT OF CONDITIONS The undersignetl owner/applicant hereby ac�rees to hold and save harm• less Ihe City of Everett Irom any and all daims for damages, costs, expenses, or causes of action that may arise because ol installation and mainlenance ol the improvement or olher righFol-way use nereto applied for and furlher agrees to remove same upon notice trom lhe Cily and to replace public propeCy damaged Ihereby. � / I ='� _ , �'�� 1. f t8'C-�-�.— �1�� % /LJ Signature ol! pplic.int Date WORK AUTHORI2ED BY THIS PERMIT MUST BE STAHTED WITH�N 1A0 DA1'S OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PtRMII MAY BE CANCEL�ED BY THE CITY UPON ANV STOFPAGE OF WORK ON THI3 PROJECT OVER 90 DAYS �URATION.