3202 W MUKILTEO BLVD 2016-01-01 MF Import

% 35'-=�-: Date_��Y' Application For PUBLIC WORKS PERMIT Print or Type Only Address Describe Proposed Work Prolect Address (if known) Zip PubLr. Wo�hs Pormii e�Y `� � — /�OJ eme oao�. • Q cT�f(i � � PubLc wo�k! Feo S Total Fee Losa Appl Fea PaIE S Bolance0uo S �� 33�- Phone Zip rnone Attach lour (4) copies of plans lor proposed work • Draw to scale and note the foltowing as applicable: • Property Lines • (.enter�ine of s�reet • Oulline and dimensions ol all r,r.isting and • Indicate North proposed structures on the lot • Show a�y proposed grading changes • E,cisting and proposed utilities • Show measurements FINAL INSPI Approved as everett e PERMIT CONDITIONS 1. All cails for inspoction shall be ��ade 24 hrs. in advance - phone �59•881 5. 2. All work shell bc performed in accordance with this permit and current City of Everett Design and Construction Standards and Specitications. 3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800•424•5555. PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everetl, WA 98201 Phone: 259-8815 ACKNOWLE�GEMENT OF CONDITIONS � � � a The undersigned owner/applicant h�reby agrees to hold �nd save harm- less the Ciry ol Everett Irom any and all claims for damages, costs, expenses, or causes of action tnat may arise because ol installation and maintenance ol the improvemenl or other right-ol•way use hereto applied tor and furlher agrees to remove same upon notice Irom the City and lo replace public property damaged thereby. _��(T �� Signature ot Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 780 DAYS OF DATE PERMITISISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.