4631 MARBLE LN 2016-01-01 MF Import

�,,�} 1 � �;.��-� Date��fl� App�ication For PUBLIC WORKS PERMIT Print or Type Only l MaRE �� LsNE- P.ddress �'� g7- 2i3 Pu0!ic Workc Permit + 31dp. Dept • Pueiic Works Fee s Tolal Feo Less AppL Fee PaiE S Balance Oue a 20� W Applicant Ma�ling Address City Zip Phone Descri6e Proposed Work Prolect Address (if known) 7�� '� Attach tour (4) copies of plans for proposed work • Oraw to scale nnd note the lollov�ing as applicable: • Property Lines .• Centcrlioe cf street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls for insFection shell be made 24 hrs. in advance • Phone 259•881 5. 2. l+II work shell be performed in accordance :•ith this permit and current City of Everett Design and Construction Standards and Specifications 3. Call Locelion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424-5555. %jilq,r,,rxh� /iEiC.6�r �F'.FE"�CE A�a•vcr /r�,q,eacF L 9.✓� T BE S1Z ~ 0' ck�"' P pz..l�y �'�'U % Approved for Constr i6n � Date �� 1��7 FINAL IN PE TION Date A�proved as Constructed everett PUBL�C WORKS D[PARTMENT � 3200 Cedar Street Everetl. WA �J8201 Phone: 259•8815 ACKNOWLEDGEMENT OF CONDITIONS � � O a The undersigned owner/applicant hereby agrees to hold and save harm• less Ihe City of Everett irom any and all claims for damages, costs, ezpenses, or causes of nction that may arise because of instatlation and maintenance of the improvement or other righ4of-way use heretc applied lor and furiher agrees to remove same upon notice from the City and to replace public property damaged thereby. � T � � Sipna / cant Da e . WORK R.UTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMII� M:�Y BE CANCELLED BY THE C1TY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.