5106 NARBECK RD 2016-01-01 MF Import

Date Ia C�-� Applicatlon For PUBLIC WORKS PERMIT Print or Type Only �' � G�c Address Mailing Address Describe Proposed Work Prolect Address (if known) J- Pu01�cWorkePer f • �C-Z� �� I emo. oeo�. r � rublicwod,fee s Totel Pee Loia A00� Fao Paltl S. Q� Belence �ua S z� „_ _� = iDa. Zip y� Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: • Propeny Lines • Centerline of street • Outline and dimensions of all existing and � Indicate North proposed structures on the lot • Show any proposed gratling changes � Existing and proposed utilities � Show measurements PERMIT CONDITIONS � 9�a7� � �a�-y�� 1. All calls for inspection shall be mede 24 hra in advance - phone 259•881 5. 2. All �vork shall be pertormed in accordance with this permit and current C+ty of Everett Design and Construction Standarifs end Specilicationa 3. Cell Lor.ation Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800•424•5555. everett PUBLIC WORKS DEPARTMENT 3200 Cedar Street � Everett, WA 98201 Phone: 259�8815 ACKNOWLEDGEMENT OF CONDITIONS W H � � � � O a The undersigned owner/applicant hereby agrees to hold and save harm- less U^ City ot Everett Irom any and all claims lor damages, costs. exper.ses, or causes of action that may arise because of instal�atiun and maintenance of lhe improvement or olher right•ol-way use hereto applied for and turlhar agrees to remove sane upon notice Irom the City and to replace public property damaged t��ei^.by. I .� Signature ol pplicant ate WORK AUTHORIZED BY THIS PERMIT MUST BE STARTE WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETIOiJ. THIS PERMIT MAY BE CANCEILED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVEA 90 DAYS DUF7ATION.