2414 W MUKILTEO BLVD 2016-01-01 MF Import

Date ��l�iS � � � I Pu01ic Works Permit s� �- �/ � Application For eiee�oen�.• � PUBLIC WORKS PERMIT Print or Type Onl� � ng Address Descri6e I�roposed Work Project Address (if kr,own) Zip City Zip Public \Vorka Fee Total Feo , — Less ApPL Feo PaiO $ _ Balenca Due 7� _ Attach four (4) coF�es of plans for proposed work • Draw to scele and note the following as applicable: • Property Lines • Cen�erline of slreet • Outline end dimensions of all existing end • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs, in advance - phone 259•881 5. 2. All work sheil be performed in accordance with this permit and current City of Everelt Design and Construction Stendards and Specificetions. 3. Call Locatlon Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•E555. PciG'�,� ��,��,�s- �.��>..�„— ,�/a; �E��,,e�� � Approved for Consiruction Date FINAL INSPECTION Approved as Consiructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everelt, WA 98201 Phone: 259•88 7 5 ��/� Q/�� �<,�i ACKNOWLEDGEMENT OF CONDITIONS W H � The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from eny and all claims tor damapes, costs, ezpenses, or causes of action thal may nrise beceuse of installation and mainlenance of the improvement or other right�ot-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant Date WORK AUTHORIZED BY THIS PEfiM1T MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER �S TO BE DILIGENTLY PURSUED TO COMPLETIOtJ. THIS PERMIT MAY BE CANCELIED BY THE CITY UPON ANY STOf'PAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.