7111 MORGAN RD 2016-01-01 MF Import

Date i�, g� ,-. Application For PUBLIC WORKS PERMIT Print or Type Only Mailing Describe Proposed Work ��'� ``� Prolect Address (if known) Attach four (4) copies of plans for proposed work • Drav • Property Lines • Outline and dimensions of all exisling and proposed structures on the lot • Existing and proposed utilities � City City to scale and note ihe following as applicable: Public Waiks Parmlt e Bltlp. Dept. e Pu�lic Works Fee s Toial Fea Less Apol. Fee Paia $ Balunce Due S • Centerline of street • Indicate North • Show any proposed grading changes • Show measurenients PERMIT CONDITIONS 1. All cal�a for inspectiun shall be mede 24 hrs. in advance • phone 259•8815. 2. All work shall be performed in accordance with this permit and current City ot Everett Design and Construction Stendards and Specificetions. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. �l/�/C L�h9/1�f' T�F"2/l7�T ir/OT ��l�di/'dr'O, Approved for Construction Date FINAL INSPECTION D•ete Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Slreel Everetl. WA 98201 Phone:259-8815 ��/��8 y ( G %�� ACKNOWLEDGEMENT OF CONDITIONS The undersigned ow�er/applicant hereb�/ agrees to hold and save harm- less the Ciry of Everett Irom any and all claims for damages, costa expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-of•way use hereto applied lor and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signalure of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEP IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.