954 NORTH PARK DR 2016-01-01 MF Import

Date� TO POSTI Application For PUBLIC WORKS PERMIT Print or Type Only -ti-a �o/Z�o blit WOfkS PC/mil s eiae. o�o�. + 9 �,�� 3 % .�i Pubbc Worhs .'ee Totnl Fcc S Less no��. Fce Paitl $ n � Balan<e Due S ��C7c./^ Cw o,. %�io�n� Ao (3ox `ll4�i f�iPlli�ilu� %eY/9 `-/59-3dS�e Owner 1 Mailing Address City 2ip Phone Mailing Describe Proposed Work Prolect Address (if known) ��Y y Zip Attach four �4) copies of plans for proposed work - Draw to scale and note the lollowing as applicable: • Property Lines • Outline and dimensions oi all ezisting and proposed strucWres on the lot • Existing and proposed ulililies • Centerline of street • Indicate Norih • Show any propo5ed grading changes • Show measuremenis PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs, in advance - phone 259•8810. 2. All work shall be performed i� accordance with this permit and current City of Everett Design and Construction Stenderds end Specifications. 3. Call Location Underground Service 48 hrs. 6efore you dig. TOLL FREE NUMBER 1-800-424•5555. �R�.�� Vl�`�-e� �i�25�9t> Approved tor Construc ' n Date �� ' 6-��-�/ FINAL INSPECTION Date Approved as Constructed evere[t PUBLIC WORKS DEPARTMENT � 3200 Cedar Slreet Everett, WA 98201 Phonc:259�8810 ACKNOWLEDGEMENT OF CONDITIONS W H � � O � � O a The undersigned owner/applicant hereby agrees to hold and save harm- less the City ol Everell Irom any and all claims lor damages, costs, expenses, or causes of action that may arise because of installation and maintenance ol the improvemen[ or other right-ol-way use hereto applied �or and further agrees to remove saine upon notice Irom the City and to re,yface public property damac�ed ihereby. C, /, f� WORK AUTHORIZ D Y S PERMIT MUST BE STARTED WITHIN 180 DAYS OF D PE IT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. TH�S PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.