424 MORGAN RD 2016-01-01 MF Import

Date � C�' �S ! ppplication For PUBLIC WORKS PERMIT Print or Type Only ST/i T ,�rciO Y %�i �1t% —' Mailing Address �/ti.i�L �nc, /27ir �� /� City Pu�iic Worka P�erym-il • /Q� BIEp.DeO�.+�J /S� U" Pueiic wo�ks Fao S Totel Fee Less ADG� Fee PaiE S_ Balance Due a ��/ Gv�RI.[.f / C � � �� Cit� Describe Proposed Work � � y Z � ��L�� t�� !/C ✓ T��SS�S Project Address (il known) y� Attach four (4) copies of plans for proposed work • Draw to scale and note the lollowing as applicable: • Property Lines • Centerline of street � Outline and dimensions of all exisling and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements Phone Phone PERMIT CONDITIOfJS t. All calls for inspection shall be made 24 hrs. in advance • phone 259•881 5. 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Lucatlon Underground Service 48 hrs. before you dig. TOLI FREE NUMBER 1•S00•424-5555. �n �i�� G' %%�S /D�i��o�T L'Ft,�G%�'�� ��!��.�.� Approved for Construction ��e FINAL INSPECTION Date Approved as Constructed everelt PUBLIC JVORKS DEPARTMFNT � 3200 Cedar Strnet Everett, WA 98201 Phone: 259-8815 �� .'J^ � ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm- less the City ot Everett Irom any :�nd all claims for damages, costs, expenses, or causes of action that may arise because of installation and maintenance ol the improvement or other right•of•way use hereto applied for and lurther agrees lo remove same upon notice irum the City and to replace public propeity damaged ihereby. Signature ot Applicant Date 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 CITV UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS L URATION.