1910 W MUKILTEO BLVD 2016-01-01 MF Import

Date.�� Application For PUBLIC WOR'K5 PERMIT Print ur Type Only City .� Applicant Describe Proposed Work Prolect Address (il known) Public WoiMs Pe�mil •` /� BICB. Dept ♦ /� �V I Pubbc Worb Fee ;. Totel Feo Ln!f AOG� Fae Paid S �alence Dua s Phone zip rnone Altach lour (4) copies of 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 North • Show any proposed grading changes • Show measurements PERMIT CONDITIONS 1. All c�lls for inspection shall be made 24 hrs. in advance • phone 259•881 5. 2, All work shall be performed in accordance wit:i this permil and current City ol Everett Dasign and Construction Standards and Specificationa 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424•5555. �v fE��% ti�i Approved for Cons�ruction Date FINAI INSPECTION Date Approved as Conslructed everett PUBLIC WORKS DEPARTMENT � 3200 CedarStreel Everett, WA 98201 Phone: 259•8815 /'�'��/i,�E,C� 9�� 6 �-,�� ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save hai m- less the City of Everett lrom any and all claims for damages. costs, expenses, or causes ol action that may arise because of ii�sta�lation and maintenance of the improvemen� or other right•of•way use hereto applied for and further agrees to remove same upon notice from the Ci1y and to replace public property damaged thereby. Signalure ol Applicant ��1e WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIl IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY �E CANCELLED BY THE CITY UPON AN'! STOPPAGE OF WOFK ON THIS PROJECT OVER 90 DAYS DURATION.