2914 MCDOUGALL AVE 2018-01-02 MF Import

Dat-�i*/' Applical on For PUBLIC WORKS PERMIT Print or Type Only cv,r. rig CI, Applicant Mailing Address Describe Proposed Work Project Address (if known) Public Work. Permit e Bldg Dept. a Public Works Fee /7 n Total Fee s u Lou soot Fee Paid S Balance Due s �� "2D� �S�-tins Zip Phone Zip Phone--_---- Attach four (4) copies of plans for proposed work- Draw to Scale and a6te it following as applicable. • Property Lines • Centerline o' street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilitiv • Show measurements PERMIT CONDITIONS I. All calls for inspection shall be made 24 hrs. in advance - phone 259-881 5. 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBEP 1-800.424.5555. n �ppr ed or Construction atc .FINNALIN3SPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 Phone: 259.8815 ACKNOWLEDGEMENT OF CONDITIONS W CHw] In O al no Fm ' •IO/ O an The undersigned ownerlapplicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, costs, expenses, or causes of action that may arise because of Installation and maintenance of the improvement or other right-of-way usa hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applic nt I Z t Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRCJECT OVER 90 DAYS DURATION.