1010 OLYMPIC BLVD 2016-01-01 MF Import

II Date��Q ,.m� � Applica, .� For PUBLIC WORKS PERMIT Print or Type Only Sc, »�a. Appllcant Describe Proposed Work Projecl Address (it known) c�iY a�v � ounec wa�ws �vr�,n . _ • � ein9. ocot . _�r/� .Z 3 Z.S --- Vue��c wm�s Fce toiei Fce 5 ___ 1e55 Nn. i iee PaiO � — Baiancr Due S 9�z�s �a�-��sti Zip Phone Zip Phone Attach four (4) copies of plans lor proposed work - Draw to scale antl noie the lollowing as applicable: • Proper�y Lines • Outline and dimensions ol all existing and proposetl siructures on the lot • Exlsting and proposed uti6ties • Centerline ot street • Indicate North • Show any proposed grading chanqes • Show measuremen!s PERMIT CONDITIONS 1. All calls tor inspection shall be made 24 hrs. in advance • phone 259-8810. 2. All work shall be pedormed in accordence �th this permit and current City of Everetl Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. beFure you dig. TOLL FREE NUMBER 1-800�424•5555. �� f �� �'6-��,e lc'o��l, f�2.,>.< ��'�_,...� .�,.c,l' � l;c t� //-! -,99 Approved lor Construction FlNAL INSPECTION Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Evere�t, WA 98201 Phone�.259�8810 ACKNOWL[DGEMENT OF CONDITIONS W H � I� � � O � � � a The undersigned owner/applicanl hereby agrees to hold and save harm- less the City ol Everet� Irom any and all claims for damages, costs. expenses. or causes of action tha� may arise because of installation and maintenance ol ihe improvemeN or other righFof-way use here�o applled lor and turther a�rees �o remove same upon notice trom Ihe ��0 City and to replace public property damaged Ihereby. Date Signalwe ol ApplicaM Date WORK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND TIIEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WppK ON TIIIS PRO.IECT OVER 90 DAVS DURATION.