2322 W MUKILTEO BLVD 2016-01-01 MF Import

Date CA� � Application For PUBLfC VUORKS PERMIT Print or Type Only Mailing Address Describe Proposed Work Project Address (if known) Ciry Cily Zip Pu06c WorFs Pormit a BItlB� �e0�- • �� Pu1rLc Works Fee S Tal.11 Fee LoSs AoO�� Feo Pnia S Belanca Oue Attach lour (4) copies of plans for proposed work • Draw to scale and note the following as applicable: • Property Lines • Centerline ot streel • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utililies • Show measurements Phone Phone PERMIT CONDITIONS 1. AI� cells for inspection shall be made 24 hrs. in advance - phone 259•881 O. 2. Ail work shall be performed in accordance with lhis permit and current Ciiy of Everett Design and Construction Standards and Specilications. 3. Cell Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800-424•5555. lp��/ B'B /(/!T� /Lc�2G/� �✓'v Approved for Construction Date FINAL INSPECTION Approved as Constructed everett PUBUC WORKS DEPARTMENT � 3200 Cedar Slreet Everett. WA 98201 Pl.one: 259•BB70 ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everelt from any and all claims for damages, costa expenses. or causes ol action Ihat may arise 6ecause of installation and main�enance ol the improvemenl or other right•of-way use hereto applied for and further agrees lo remove same upon notice from the Ciry and to replace puhlic property damaged Ihereby. Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DI1TE PERMIT IS ISSUED AND THEREAFTER IS TO 8E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVGR 90 DAYS DURATION.