2401 W MUKILTEO BLVD 2016-01-01 MF Import

Date�cL� (�� Application For PUBLIC WORKS PERMIT Print or Type Only Owner Applicant Mailing Address Describe Proposed Work � ( t�� Projed Address (il known) Attach four (4) copies of plans for proposed work - Draw to scale and note Ihe following as applicable: • Property Lines • Outline and dimensions of all exicting and propnsed structures on the lot • Existing and proposed utilities Public Woiks Peimil • 614p. Dep1. • PobLc Works Feo TOIaI Foe s lass Appl. Feo Paitl $ Balance Due S • Centerline ol slreet • Indicate Norih • Show any proposed grading changes • Show measurementa Phone PERMIT CONDITIONS 1. All calls fo� Inspection shell be made 24 hrs. in advance • phone 259•881 O. 2. All work shall be peAormed in accordance with this permit and current City of Everett Design and Construction Stenderds and Specifications. 3. Call Location Underground Service 48 hrs, before you dig. TOLL FREE NUMBER 1•800•424•5555. RG� f�`�i �'� 2� % � �� Approved for Construction Dale FINAL INSPECTION Date Approved as Consiructed rverett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259�BB70 ACKNOWLEDGEMENT OF CONDITIONS W H � � � �" � � a The undersigned owner/applicanl hereby agrees to hold and save harm- less the G;y of Everetl from any and all claims for damages, costs, expenses, or causes ol action that may arise because of installation and maintenance of lhe improvement or other righFohway use hereto applied lor and lurther agrees to remove same upon notice Irom the City and to replace public property damaged thereby. Signature of Applicanl Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT �S ISSUED AND THEREAFTER IS TO 8E DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.