1822 RAINIER AVE 2018-01-02 MF Import

Date 75 Applicanr n For PUBLIC WORKS PERMIT Print or Type Only l� Andress no City Pubbc Works Permit • C/iL\L� / BIUB. Deal • — - -- Pubbc Works Fee S Total Fee Less Areal Fee Paid 5 Balanre Due ^a_L.---- uA 9�,6 1�p Applicant-- Maihnq Address City ---.Zip ---- � 'N Describe Proposed Work Pam_ L ----- --- -- - - Project Address 11f known! Attach four (4) copies of plans for proposed work - Draw, to scale and note the following as applicable: • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements NE Phnnn PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in aavance - phone 259.8810. 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800.424.5555. It /¢s 'PW sa pion P`30(f FINAL INSPECTION Date Approved as Constructed 6�PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett. WA 9l+201 Phone:259-8810 W H co O H V� 0 a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages. costs. expenses. or Causes of action that may arise because of installation and maintenance of the Improvement or other right-of-way use hereto applied fo d further a to remove same upon notice from the Cd vtd o Plata pu c pr erty damaged thereby. Y Sic tature of Applicant Date WORK AUTHORIZED BY THIS PERMIT 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 BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.