7827 GRANT DR 2016-01-01 MF Import

Date r�'' / �i Applicalion For PUBLIC WORKS PERMIT Print or Type Only 2ip ✓ ��:�,� „-o,.= �.e�� 7 �� ome oeni • Pu�lk Worhs Fac Tatel Fea $ Less AOP�- Fee Pe�O $/ Balanco Duo %S SA M C' App�icant Mailing Address City Zip Phone Describe Proposed Work //fL,Sfi4 L/ y�� /y,4�Q(,� �G� 2 S/,OE' S'ElU � Proiect Address lil known) Attach four (4) copies ol plans for proposed work • Oraw to scale and nole the lollowing as applicable: • Property Lines ,• Centerline ol street • Outline and dimensions of all ezisting and • Indica�e Norih proposed s�ructures on the lot • Show any proposed grading changes 1 Existing and proposed utilities • Show measuremenls PERMIT CONDITIONS 1. All calls tor inspection shall be made 24 lirs. in advance - phone 259•881 5. 2. All work shall he performed in accordance wi�h this pennit and currenf City of Everett Desi9n and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. �-i�, /'--�-r a�� , �ct /� /,.� Approved as Construcled v V everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Sireet Everelt. WA 90201 Phone:259-8815 ��. �� 7- / �� -�.'�% ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicanl hereby agrees to hold and save harm� less the City of Everett trom any and all claims tor damages, cosls, expenses, or causes ol action ihat may arise because ol installation and maintenance ol the improvement or other riqhPol-way use nereto applied f nd lurther agrees to remove same upon notice Irom the City�n to 8place publir, properry damaged thereby. -�� ''�j / � �o-�_ Sinnature ol Applicant 'Date WORK AUTHORIZEU BY THIS PERMIT MUST BE STARTED WITIiIN 180 DAYS OF DATE PEFiN11T IS ISSUED AND THEREAFTER IS TO BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCGLLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAVS DURATION.