8107 HAMLET LN 2016-01-01 MF Import

Date� Application For PUBLIC WORKS PERMIT Print or Type Only i; , we ��era ' a`lo'-1:i ')�o�� y ,��.) � o N IZ' ress; �; + �.w. APPlicent ` �l.jt7q�.� manmyn�� - .::,�� 1r' i.-� :7 : • Describe Proposed Work Prolecl Address (if known) Pu01ic Works Parmit � "� 2 6 eiay. oeo�� Pu01it Woiks Fee ` '�� , � Lj Tolal Fae — Less Appl Fee Paitl S_ Balanca Ouo s��' O U �� ZIp Zip Attach four (4) copies of P�ans for proposeo worn • Draw to scale and note � Ceniterline of sVee� abie: • Property Lines • Indicate North • Outline and dimensions of all exisling and � Show any proposed greding chan9es proposed structures on the lot • Show measurements � Existing and proposed uliliiies �� 353-baa Phone Phone PERMIT CONDITIONS 1. Ail calls tor inspection shall be made 24 hrs. in advance • phone 259•881 5. 2. All work shall be performed in accordance with this permit and current City ot Everett Design and Conslruction Standards and SpecVfications. 3. Cal� Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•55 . �I� /U � !� Approved for Construction --"- � �� J /J-f'y� FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Sireet Everett. WA 98201 Phone: 259•8815 W H � � Z O � � O a ACKNOWLEDGEMENT OF CONDITIONS The undersigned ownedapplicacl hereby agrees to hold and save harm- less the City ol Everetl Irom any and all cleims for damages, cests, expenses, or causes of ection that may arise because of installation and maintenance of the improvement or other right•ot-way use herelo applied (6t� nd further agrees to remove same upon notice from lhe Citv�and to r�Place public property demaged thereby. Sif r(ature ol Applicant - 80RDAYS OF DATE PERMIT ISEISSUED ANDBE EREA TER ISHTO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY TI1E CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAVS DURATION.