9320 MEADOW WAY 2018-01-01 MF Import

� va�� •� Date Pub6c Wo�hs Permil• Blap Dept• App:icalion For � PUBLIC WORKS P�Rh'IIT °°°"`"'°'".`°° --- iolel Fee s _QL� pG L¢ss ApO�Fee Pe�E S�Y�a�--/� // � � g $ Balence Due S� � Print or Type Only Prince of Peace � a � Lutheran Churcli 9320 Meadow W�y � Everetc 98204 337-6663 _ Owner Mading Addresso o N� Cily ZiP �� Phone Prince of Peace �' � � s Lutheran Church 9320 Meadow 47�r �erett 98204 337-6663 _ Applicant Mailing Address Ci�y ZIP Phone /.- DeSc�ibePropoSedWork F1�r"�11C1 arade aoo-roximatelv 4�� CVS Of 2XC25S SO115 from the h��emenr Px�avati � *�- �_^^ �a�v�ddition located at the i a6ovP a9dr e�^�h �f f; 11 1-- �� ap.proximatP].y 2' deep and will � r�nvar an araa ��nrnx� �m?tA��7 F.onn RF_ R�P att� h d ci e c�1dG £O ProiectAd�e�S�(lk�ow�i1 tion. q29p MPadow Way E��Arati- . WA 98204 � Attach lou:(4�copies of plans tor proposed work•Draw to scale and note the following as applica6le: � • Property Lines • CeNerline of street � � Outline and dimensions of all ezisting and • Indica�e North propos=d structures on the tot • Show any proposed grading changes � Existing and proposed u�ilities • Sh�w measuremen�s M W DO NOT WRIT� BELOW THIS LINE O PERMIT CONDITIONS 1.All cells for inspection shall be made 24 hrs.in advance•phone 259•8810. � 2.All work shall be peAormed in accordance with this permit and currert City of Fverett Pesign and Construction Standards and Specificetions. 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800�424•5555. � yC,�"S lU}.l ��T71C //L.c7� /j rJ� .,!.'J//C C �T1�'� � .�5�y i/�J•S/'r�'��,�' � � O 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 lor damages, cosls, expenses, or causes of action ihat may arise because oi inslallalion and mainlenance ol Ihe improvement or olher nght-obway use hereto - ��'� "�� applied lor and lurther agrees to remove same upon notice irom the Ap ove Jo" ons ion _ ,. �a�e Cily and to reVlace public property damaged thereUy. i � �� ,� � 1 � � � /, i � � D' 1 n i FIN LINSP ON� Date 1 ��W t�61dr�_—�b�zo�$� Appioved as Constructed SignaWre of APplican� --� Date everett PUBLIC WORKS DEPARTMENT WORK AUTHO.'�28D BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DnTE f'ERMIT IS ISSUED AND THEREAFTER IS TO � 3200CedarStreet BE DILIGENTLY PURSUED TO COMPLETION. THIS PEFMIT MAY BE �veret!.WA 98201 CANCEllEO BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS Phone:259-BB70 PROJECT OVER 90 DAYS DURATION.