2309 W MUKILTEO BLVD 2016-01-01 MF Import

Date�`L- `�� Application For PUBLIC WORKG �ERMIT Print or Type Only Owner SG� � Applicant Destri6e Proposed Work Mailing Address � Pun�m Wo�Fs Pmm(i�t� •� I /�/ C Z Bltlg Depl. + �L `� PUG��c N'oiks Feo To�a� Faa s -- Less Aoa� Fea Poid $ enlanco oue S �r 3.5(c—(�DGS �i F✓a;Pt� 98�3 ��55 S�Z./ Ci�y Zip Phone City Zip Phone Project Address (if known) � � LL"� �a � � � �� r , � r�•n ,iz� �, �n _ A;[ech four (4) copies of plans for proposed work - Draw to sca�e and note the following a.; applicable: • Property Lines • Outline and dimensions ol all existing and proposed structures on the lot • Ezisting and proposed utilities • Centerline of street e indicate North • Show any proposed gradinc� changes • Show measurements PEP.MIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance • phone 259•8815. 2. All work chell be performed in accordance vrith this pennit and wrrent Ciry of Everett Design and Construction Standards and Specificalions. 3. Cail Location Underground Sorvice 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424•5555. //87 �LJBG/G L�/.J/',f's /�Far?iT NO% /��Fc�G//'C� �� Approved for Construction Date FINAL INSPECTION Date Approved as Consiructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Slreet Everetl, WA 98201 Phone: 259-8815 ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hola and save herm- less lhe City of Everett from any and all claims for damages, costs, ezpenses, or causes oF action that may arise hecause ol installation and maintenance ot the improvement or other right-ol-way use hereto applied for and turther agrees to remove same upon notice irom the City and to replace public property dama9ed thereby. Signature of Applicant ua�e WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TD BE DILIGENTLY PURSUED TO COMPLETION. THIS PERM�T MAY B� CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURP.TION.