3434 MCDOUGALL AVE 2018-01-02 MF Import

Application For PUBLIC WORKS PERMIT PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 259-8810 Date 3J,113 1910 Public Works Permit N 8 d Building Permit M TYPE OR PRINT ONLY Public Works Fee $ '--&— S wd 14(2vs '.s1 t C'Duk �y l� Z M w. ore i,+�r' 900,,P) 3 $19-bal Owner Mailin dress City Zip Phone L))� 1c)i o., 7,93D Lr," prep- ii ►r Applicant Mailing Address City Zip Phone Describe Proposed Work ■ ■ ■ /n�- N PROJECT ADDRESS (if known) 3102 — Me bounS , L. At Ac GO r!! Attach four (4) copies of plane for proposed work - Draw to scale and note the following if applicable: 7 3`/02- C()C i/Ar O *Property Lines `Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities 'Centerline of street •Indicate i forth 'Show any proposed grading changes `Show measurements PERMIT CONDITIONS: 1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. 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. LL FREE NUMBER 1-OD0-424-5555. 4, U52 4ra{f,c, Co► -,trot peN C,L C4U �4h&rc! 070/A d Or as lenofed � by +he C'l {y PUbLl G (.4Xr'kS Zlspec-<Oif' Approved as Constructed z O O a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harmless 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 use hereto applied for and further agrees to remove same upon notice from the City and to replace public pmperty WORK AUTHORIZED BY THIS PERMIT MUST TIE STARTED WITHIN 180 DAYS OF DATE F COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE