3419 OAKES AVE 2018-01-02 MF Import

PER Application For PUBLIC WORKS PERMIT Date PUBLIC WORKS D: OARTMENT Public Works Permit F 3200 Cedar Street Everett, WA 98201 259-8810 Building Permit M TYPE OR PRINT ONLY_, _ Public Works Fee $ Al I LL/ M lXA K r!/ S ll`'7/� (�/kE� Eaatc- ,�� gizo / Owner Mailing Address C1y Zip rJ Describe Proposed Work Phone LONG - of IX%\ W\v PROJECT ADDRESS (if known) Attach four (4) copies of plans for proposed work -Draw to scale and note the following 1 appli ble: � �� 01IA •Property Lines `Outline and dimensions of all existing and proposed structures on lot •Existing and" uti"6 *Centerline of street •Indicate North 'Sho%. any proposed grading chang 'Show measurements PERMIT CONDITIONS: 1. All calls for inspection 5nall be made 24 hours in advance - phone 259-8810. 2. All work shall be performed in accordance with this permit and current City of Ev tt Design and Construction Standards and Specifications. 3. Call LoRation Underground Service 48 firs. before you dig. TOLL FREE NU BER 1-800-424-5555. & Jed - ,A 11'e Approved for Construction Date FINAL INSPECTION Date Approved as Constructed i 05 eTa'eS S -1�0M — reeve l I z123/qcJ W H 0 z 0 0 a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harmless 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 for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant Datn 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.