870 OLYMPIC BLVD 2016-01-01 MF Import

Date�ci7 Application For PUBLIC WORKS PERMIT Print or Type Only Owner Describe Proposed Work Project Address (if known) Ciry � City �] � PuELe Works Peimit • p�/ —f 61tl9.0ep1. � _� ��T Y' / 3 Public WmkS Fee s Talal Fea Leas AOPI. Fee Paitl S Balanca Oue S Attach four (41 copies of plans for proposed work - Draw to scale and note the following as applicable: • Propeity Lines .� Centerline ot street • Outline and dimensions of ali existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS rnone Phone 75- 1. All ca�ls tor inspection shall be made 24 hrs. in advence • phone 259•8815. 2. All work ahell be performed in accordance with this permit and current City of Everett Design and Construction Stenderds and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424•5555. 'f% %�c%C�GiC- 6tic�.(k'S f�C'/X'/% ��El7i U/.�'E�p �%-/� 87 ��J Approved for Constraction Date FINAL INSPECTION Approved as Construded everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone:259-8815 ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and sava harm- less the City ol Everett from any and alt claims for damages, costs, ezpenses, or �auses of action that may arise because of installation and maintenance of the imnrovement or othe� right-ohway use nereto applied for and further egrees to remove Same upon notice irom the City and to replace public property damaged thereby. Signature o� Applicant Date WORK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHIN 180 DAF'S OF DATE PERMIT IS ISSUED AND THEFEAFTER IS TO BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.