4920 OCEAN AVE 2016-01-01 MF Import

Date�.3�(_?�� Application For PUBLIC WORKS PERMIT Print or Type Only � .i ary Describe Proposed Work Projecl Address (if known) Pupi¢ Worws Parmn a �i�� . ��' J�LioC-- 6iop Deo� • Pu�lic Works Fea TOIAI fBC 'S LessAppl FcePa�O S BdIdI1CP. DUP. S �� 3s 3 -�``��— 2ip Phone Atlach lour (4) copies of pians lor proposed wotk - Draw to scale and note the following as applicable: • Property Lines • Centerline of street • Outline and dimensions of aU exis�ing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed "'ilities • Show measurements PERMIT CONDITIONS t. All cells for inspectlon shall be made 24 hrs. in advance - 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. Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424•5555. � `7 Approved lor Constru on ate i / ��C��/ �� FINAL �NS ECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett. WA 98201 Phone:25�J�8B10 ACKNOWLEDGEMENT OF CONDITIONS W H � � � O � � O a The undersigned owner/appli[an� hereby agrees to hold and save harm- less the Ciry of Everett irom any and all claims for damages, costs. expenses, or causes of action that may arise because of installation and maintenance ot Ihe improvemenl or o�her righFol-way use hereto applied for and luriher agrees to remove same upon notice Irom ihe City and to replace public property damaged thereby. �„�k.. �'`C�..,P y-ir-s� Signature of Appli ant Date WORK AUTHORIZED BY THIS PERMIT MUST 8E STARTED WITHIN 180 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED i0 COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.