1431 MCDOUGALL AVE 2016-01-01 MF Import

';z �� . Date�_1_t� � �-.,�,��,� �vo�hs ��„��,,:� .� % I Bitl9. Dcot. • �—J�� Applicalion For P�! sLIC WORKS PERMIT Print or Type Only Pu�l¢WorksFee 5 Total Feo Less ApP�- Fee Pald $ Balanec Due � Describe Proposed Work 1� 1 �7 �+ Projed Address (if known) Attach four (4) copies ol plans for proposed work - Uraw to • Property Lines • Outline and dimensions of all exisling and proposed siruclures on the lot • Existing and proposed ulilities PERMIT CONDITIONS and note the following as applicable: • Centerline of street • Indicate North • Show any proposeC 9rading changes ! Show measurements 1. All calis for inspection shall be made 24 hrs. in advance - Fhone 259•881 5. 2. All work shall be performed in accordance wilh this permit and current Cily ot Evere�l Oesign and Consiruction Standards and Specifications. 3. Call Location Under�round Service 48 hrs. before you di3. TOLL FREE NUMBER 1•800-424-$555. ' � � �-�i� !�'�:� ��r��tit �t Approvca lor Const�uclion FINAL INSPECTION Date Approved as Conslructed ee�erett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Evereti. WA 98201 Phone:259-8815 v�2``� 9�� ACKNOWLEDGE�IENT OF COIJDITIGNS W H � � � 0 H N Q a �fho undersigned ownedapplicaN h=reby agrees lo hold and save harm- !ess the City o1 Everett from any and all claims lor damages, costs, expenses, or causes ol aclion that may arise because of installation :and maintenance of the improvement or other right-of-way use nereto applied for and turther agraes to r�,nove same upnn notice from ihe Ciry and to replace public properry damaged thereby. 3ignature ot ApP�icanl Date -NORK AUTHORIZED BY THIS PERMIT MUST BE STP.RTED WITHIN 180 DAYS OF UATE PERMIT IS ISSUED AND THEREAFTER IS TO 3E DILIGENTLY PURSUED TO COMPLETION. THI� PEHMIT MAY BE CANC[LLED BY THE CITV UPON ANY STOPPAGE OF WORK OW THIS 'ROJ[CT OVER 90 DAYS DURATIOIJ.