717 HAWTHORNE ST 2016-01-01 MF Import

Date�� Application For PUBI_iC WORKS PERMIT Print or Type Only Address Describe Proposed Work Project Address (if known) City � P.ibi�c Warks Permil • Bloy D¢pt � � -�p� n--�y]�a Pub��c WarMs Fae � � Toi Fee s — � Lesa APpI iee PaiE s Baiance oue S Z2O6 � Attach four (4) copies of plans lor proposed work • �raw to scale and note the following as appiicable: • Property Lines • Centerline of streel • Outline and dimensions ol ali existing and • Indicate Norih proposed structures on the Iot • Show any proposed yrading chang�; • Existing end proposed utilities • Show measurements PERMI? CONDIT�ONS 1. All calls lor inspection shall be made 24 hrs. in advance • phone 259-881 5. 2. All work shail be pertormed in accordance with this permit and wrrent Ciry ot Everett Design and Cons�ruction Standards end Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. � P� ��.�� </.�s ��,�� s- /-�b Approved a5 Constructed everett PUBIIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 38207 Phone:259•3815 � ACKNOWLEDGEMENT OF CONDITIUNS � 0 � N � a 1 he undersigned ownerl:.pplicant hereby egrees to hold and save harm� less the City ol Everett Irom any and all claims lor damages, costs, expenses, or causes ol action that may arise because of installation �� c'_� and maintenance ot the improvement or other nght-of-way use hereto applied lor a further agrees to remove same upon notice Lum the Dale City and to r�ce public prop�rfYtle�maged thereby. WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHlN 180 DAYS OF DATE PERMIT IS ISSUE(/ AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PER�11T MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.