1628 PUGET DR 2016-01-01 MF Import

oate ��q Application For PUBLIC WORKS PERMIT Print or Type Only �`//]� �� Publ�c WorhaPermit � _y�/�� Bi��] DePt a ��Z(�� _—_ Pobhc Kbrws Fce Tma� Feo g _.. Less Ano� Fee Paie g 00 e,i,�� o�� S ��O — - Mailin9 Describe Proposed Work � Fw Prolecl Address lif known� Zip Phone Attach four (4) copies of plans for proposed work - Draw to scale and note ihe following as applicable: • Property Lines • Outline and dimensions of all existing antl proposed siruclures on the lot � Ezisting and p�oposed utilities � �� 4 �4�k Y • Centerline ol street • Indicate Norih • Show any proposed grading changes • Shuw measuremenis PERMIT CONDITIONS 1. All ca�ls for inspection shall be made 24 hrs. in advance - phone 259-8810. 2. All work shall be pedormed in accordance with this permit and wrrent City of Everett Design and Construction Standards and Specifications. 3. Cai� Location Underground Service 48 hrs. before you dig. TOLL FflEE NUMBER 1•800•424•5555. � � / / � 5� - � � � � ,/_��, .r � G�'-�c_ c'A ��k-it'� , � c c r< �� _ /� �[ � � ��, ACKNOWLEDGEMENT OF CONDITIONS W H � � O � � O a The undersigned owner/applicant hereby agrees to hold and save ha�m- less the Cily ol Everett Irum any and all claims for damages, wsts. '� � /� ezpenses, or causes ol action that may arise because of installation '��, �j,��-Z,J.,� ��9 znd mainlenance of the i pro�emenl or other right-ol•way use herete �� pptietl�i�o �nd lurther rees to remove same upon nolice Irom the ion �^��_., Date City and to re lacr„p�q c property damaq�Q-thefeby. Approved as Construcled evc�rt� PUBLIC WOFKS DEPARTMF ��T � 3200 Cedar Sireet Everetl, WA 99201 Phone:259-8810 WORK A�'C,NORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DIL��ENTLY PURSUED TO COMPLETION. THIS PERAIIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.