5202 NARBECK AVE 2016-01-01 MF Import

9�19�8$ • . I PUEIic Works Permll • Date — Af?lication For emg. oao�� • 85/15442 PUBLIC WORKS PERMIT Print or Type Only Bertha L. Dilgard 5202 Narbeck Road EverAtt Public Work9 Fea Tolel Fee s Less ApP� Fee Paitl $ Balan<e Oue S 355-1293 Owner Mailing Address City Zip Phone Same Applicant Mailing Address City Zip Phone Construct Car—port Describe Proposed Work Project Address (if known) Road Attach lour (4) copies ot plans tor proposed work - Draw to scale and note the following as applicable: • Property Lines • Outline and dimensions of all existing and proposed structures on the lot • Existing and proposed utilities • Centerline of street • Indicate Norih • Show any proposed grading changes • Show measurements PERMIT CONDITIONS 1. All calls tor inspection shall be made 24 hrs. in advance - phone 259•881 5. 2. All work shall be perforined in accordance with this permit and current City ot Everett Design and Construction Standards and Specilications. 3. Call Location Underground Service 48 hrs. belore you dig TOLL FREE NUMBER 1•800•424•5555. /UD �l��l/C ,GIJ��,�� E',e�iT .�'�Q�i/,�E�O ; �� s-- Approved for Construction Date FINAL INSPECTIC N Date qpproved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 ACKNOWLEDGEMENT OF CONDITIONS W H � � � 0 a The undersigned owner/applicant hereby agrees to hold and save harm- less the City ol Everett irom any and all claims tor damages, costs, expenses, or causes of action that m2y arise because of installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice Irom the City and to replace public property damaged thereby. Signature of 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 CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.