6914 MORGAN RD 2016-01-01 MF Import

Da �I �/ Application For PUBLIC WORKS PERMIT Print or Type On�Y PUEIic Worke Permlt • / � � � � O� BIOp. Deol • A . Pu01ic Workc Fee s Tolsl Fee Lass RpD� Fe¢ PeiC s Balence Due s e� �N Describe Proposed Work Project Address (i1 known) � '" ' ' � " Attach four (4) copies ol Plens lor proposed work G Draw to scale and note the lollowing as applicable: • PropertY Lines • Outline and dim=nsions of all existing and proposed structures on the lot • Existing and proposed utilitles • Centedine ol streel • Indicate Norih • Show any proposed grading changes • Show measurements rnuuc PERMIT CONDITIONS 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 cf Everett Design and Construction Standerds and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•55 . �/1/ `° �� . ��/� �� `� ��5 �� �� � ,8� - �,� � Approved lor Conslruclion Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Sireet Everett, WA 98201 Phone:259-8815 � 0 H � O a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owrer/applicant hereby agrees to hold and save harm- less the City of Everetl Iwm any and all claims tor damages, costs, expenses, or causes ol action thal may arise because ol installation and mainlenance ol the improvement or other right-obway use hereto applied for and further agrees to remove same upon nolice Irom the City and to replace public property damaged thereby. Date Signature ol Applicant BORDAYSTOF DAT�E PERMIT ISESSUFD AND THEREAFTER ISHTO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERA9IT MAY BE CANCELIED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 50 DAYS DURATION.