2115 HARRISON AVE 2016-01-01 MF Import

oete_ I I 1_8� Application Fo� PUBLIC WORKS PERMIT Print or Type Only Address Describe Proposed Work Proiec� AdAress �if known) � [ip Attach lour �4) copies of plans for proposed work - Draw to scale and note the following as applicable: � Property Lines • Outline and dimensions of ail existing a�d proposed structures on the lot • L•xisting and proposed utilities Puei�c worAs Pci Bldp.OGpt � Pu��m Wo�ka Fce Totai Fee s Less Appl. Fee Pa�a S BalanteD�e S • Centerline of street • Indicate Norih • Show any proposed grading changes • Show measuremenis PERMIT CONDITIONS 7. All calls for inspection shall be made 24 hrs. in advance • phone 259•8810. 2. All work shall be peAormed in accordance with this permit and current City o1 Everelt Design and Construction Stendards and Specilications. 3. Call Locetion Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800-424•5555. r, � �g�i �� Approved for Construction . FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street EveretL WA 98207 Phone: 259-BB70 ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicanl hereby agrees to hold and seve harm- less the City of EvereU trom any and all claims lur damages, costs. expenses, or causes of action thal may arise because of installation and maintenance of lhe improvemenl or other tight�obway use hereto applied for and luriher agree5 lo remove same upon notice irom ihe Gity and to replace public properq� damaged Ihereby. Signature of Applicant Date WOPK AUTHORI2[D BY THIS PERMIT MUST BE STARTED WITNIN 780 DAYS OF DATE PERMIT IS ISSUED AND 7HEREAFTER IS TO BE D�LIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJEGT OVER 90 DAYS OURATION.