3006 NASSAU ST 2016-01-01 MF Import

)ate�� Appticalion For PUBLIC WORKS PERMIT Print or Type Only Address Describe Proposed Work Proiect Address (il known) G Node Perm • _ B�CO� Dept • pue�ic wo�ka Fee Total Fea s Lesa RDV� Fee Pa10 s _ Balance Due S �a-� 2ip Phone Attach tour (4) copies of pians lor proposed work • Draw to scale and note the following as applicable: • Property Lines • Outline antl dimensions of all existing and proposed structures on the lot • Existing and proposed utilities PERMIT CONDITIONS • Centerline of street • Indicate North • Show any proposed grading changes • Show measurements t. All calls for inspection shall be made 24 hra. in advance - phone 259•881 5. 2. All work shall be perlormed in accordance with this permit and current City of Everetl Design and Construction Standariis and Specifications. 3. Call Location Underground Service 48 hrs. betore you dig. TOLL FREE NUMBER 1•SOO•424-5555. /�vB��G fi,ars�s' �E;e.•,�� NoT ,PEQU%�� D hpproved (or ConsUuction FINAL INSPECTION Date Approved as Conctructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 ACKNOWLEDGEMENT OF CONDITIONS W H � � O The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett irom any and all claims for damages, costs, expenses, or causes ol action that may ari:,e because of installation and maintenance of the improvement or other right-of-way use hereto applied for and fur�her agrees to remove same upon notice from �he Ciry and to replace public properly damaged ihereby, �,2'I%�; /��' �� 3-��-8� Signature of Applicant Date WOR!< AUTHORIZED BV 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 TFIE CITY UPON ANY S'fOPPAGE nF WORK ON THIS PROJECT OVER 90 DAYS DURATION.