5110 NARBECK AVE 2016-01-01 MF Import

oa�e�-y-�s8 Applicalion For PUBLIC WORKS PERMIT Print or Type Only ess Describe Proposed Work Project Address �if knowr.; Attach four (4) copies of plens for proposed work • Draw ro scale and note the tollowing as applica6le: • Property Lines • Outline and dimerisions of all exi�ting 2nd proposed structures on the lot • Existing and proposed utilities PuClm Wo�Mo Pa�mi � � BIJB. OBpI. t 1� a�oo�wo�w�vee S Talnl Feo Less Aon�. Foe Peitl S Bamnto Due S �� • Centerline of street • Indicate Norih • Show any proposed grading changes • Shuw measurnmenis Phone Phone PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs, in advance - phone 259•881 O. 2. All work shall be peAormed in accordence with this permit and current City of Everett Design and Construction Standerds and Specifications. 3. Call Location Unaerflround Service 48 hrs. before you dig. TOLL FREE NUMAER 1•800•424-5555. :�pproved as Constructed everetl PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone:259-8810 ACKNOWLEDGEMENT OF CONDITIONS W F- � The under;igned owner/applicant hereby agrees to hold and save harm- less the City ol Everett Irom any and all claims for damages, costs, ezpenses, or causes ot action that may arise because of installetion and maintenance ol the improvement or other righl�of-way use hereto applied lor antl� rther a9r s to remove sarne upon notice Irom the C�ry� and to rep a e public r perry damageA thereby. � �-� p-�� Signatur I pplicant Date WORK U ORI2ED BY THIS PERMIT MUST BE STARTED W�THIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERh1IT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.