4917 NICHOLS PL 2016-01-01 MF Import

U —3J�2f'__7. Date.��% . Appliwtion For PUBLIC WORKS PERMIT Print or Type O�ly Address Address Describe Proposed Work — c Prolect Address (il known) � 1 � aq� i�-Hc'>�-S PL Attach lour (4) copies of pians tor proposed work - Draw to scale and nole the following as aoplicable: • Property lines • Outline and dimensions of ail existing and proposed structures on Ihe lot • Existing and proposed ulililies Pu�Iro Wo.ks Permll s �� Bidg Oeo�� Puebc worhs Foe s Tolel Fee Less ApoL Fee Paid S e�ia�«ooe S �••0 nronu • Cen�erline of street • Indiwte Norih • Show any pro�osed grading changes • Show measurements PERMIT CONDITIONS 1. All calls lor inspection sha�l be mnde 24 hrs. in advance - phone 259•8810. 2, All work shail be performed in accordance with lhis permit and currant City of Everett Design and Construction Standards and Specifications. 3. Cell Location Underground Se:vice 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424•5555. Approved for (,on/s� �➢unn • �� ✓�,�% � � 3 i 5� y, FINAL INSPECTION Date Approved as Consiructed everetl PUBLIC WORKS DEPARTMENT � 3200 Ceder Street Evereli, WA 98201 Phone: 259-BB10 ACKNOWLEDGENENT OF CONDITIO�IS W H � � � O � � O a 7he undersigned owner/applicant hereby agrees to hold and save harm� less the City ol Everell irom any and all claims for damages, costs, expenses, or causes ol action that may arise because of installation and maintenance ol the improvement or other right•obway use hereto applied lor and lurther agrees to remove same upon nolice Irom the Cily and lo replace public property damageri thereby. � -%-�3- U ��"Gn ture ol Applica Date W'ORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUEO AND THEREAFTER IS TO I3E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE (:ANCELLED BY THE CITY UPON ANY STOPPAGE OF WOFK ON THIS F'ROJECT OVER 90 DAYS DURATION.