2131 W MUKILTEO BLVD 2016-01-01 MF Import

Date 01-7-93 � � qpplfcation For PUBL WORKS Print or Type Only P 35-Z�� PERMIT Donald Senter 3621 Shore Dr Everett WA 98203 259-0918 WEiieWork�ParmH• ZZ ' a�ay.o.ou "�9195 PuOtic Worka Fee s Tat�IFee leaa �opt Fea Paid S /J� Bal�nee Due s !�� Owner Applicant Mailing Address City Zip Phone Describe Proposed Work new house Lot 2 Short Plat Pro�oct Address (il known) Attach four (4) copies ot plans for proposed work • Draw to scale and nole the following as applicable: • Property Lines • Outtine and dimensions of all existing and proposed structures on lhe lot • Existing and proposed utilities PERMIT CONDITIONS 1. All calls for Inspection shell h 2. All work shell be performed li Standards and Specification: 3. Cell Location Underground £ • Centerline of street " • Indicate North • Show any proposed grading changes • Show measurements � ��1� m�� 1 9 App ved for Construction ate FINAL INSPECTION Approved as Constructed �A��PUBLIC WORKS DEPARTMENT 3200 Ceder Street Everett WA 98201 Phone:259•8810 Date Everett Design and Construction eeR 1-800-424•5555. ACKNOWLEDGEMENT OF CONDITIONS W � � � � O The undersigned owner/applicant hereby agrees to hold and save harm• less ihe City of Everett Irom any and all claims tor damages, costs, ezpenses, or causes of action ihat may arise because ot installation and mai�tenance of the improvement or other righFol-way use hereto applied lor and further agrees to remove same upon notice from the City and to replace public property damaged ihereby. Signature ol Applicant Date WORK AUTHORIZED BY 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 CANCELLEP BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. ,