8017 HAMLET LN 2018-01-02 MF Import

/�4 Application For PUBLIC WORKS PERMIT Print or Type Only Public Works Parma eidb Debt.. % i Lc WbreFee Tote. Fee Less April. Fee Paid $ ----� Ba:ance Due S —� H� 55-coC6`L Zip Phone 1 Meiling Address Owner 5��F�IA� = r�L�• V�'RI— Cny Z P Phone Applicant Me.1.ng Address ` Describe Proposed Work -. „,le� LaK Project Address (if known) ." , ` ' Attach four (4) copies of plans for proposed work - Draw to scale and note the enllowing of as apeeit able: 0 Property Lines • Indicate North • Outline and dimensions of all existing and Show any proposed grading changes proposed structures on the lot 0 Show measurements • Existing and proposed utilities w e/ PERMIT CONDITIONS 1, All calls for inspection shall be made 24 hitsin advance - phone 259.8815. 2. All work shall be performed in accordance with this permit and current city of Everett Design and Construction Standurds and Specifications. 5. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.555 FINAL INSPECTION \ Approved as Constructed everett PUBLIC WORKS ❑ 3200 Cedar Street Everett, WA 98201 Phone: 259.8615 _Zb z O N O a ACKNOWLEDGEMENT OF CONDITIONS The undersigned ownerlapplicant hereby agrees to I ..d and save harm- less the City of Everett from any and all claims for 13'nages, costs, expenses, or causes of action that may arise because of installation and mai.rtenance of the improvement or other right-of-way use hereto land to eplacether publ 9properttyes to remove same upodamaged therebyn notice from the City Date Signature of Applicant WORK AUTHORIZED BY THIS PE I 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 STOPPAGE OF WORK ON THIS PROJECTOVER 90 DAYS DURATION. z 0 n fTl �T .-. -t N 2 m co mo --I C C)m m .o c� r 2 —4 Li m C> A m D — rn rr, •-+ N c c� r m C N -• N Fi -i r m n z x a z x m L