7232 MCDOUGALL AVE 2016-01-01 MF Import

Date�Jl_s1 0 � • � � Application For PUBLIC WORKS P�R�.�lI�' Print or Type Only ng • I PUCIicWor9aPe�mlt Bleg. DeO�. � ��//� Puellc works Fee $ Total Fe� — Lass ApO� Fea Peid v - delence Ouo S '� .3S,S-- ,;� �/ J Zip Phone L�./�`S ^ �� a � Zip Phone Describe Proposed Work �s�k� � � / � r'`�'�^-`�"�'— (,1°�'^ �—"—'� `"' — Project Address (if known) Altac'� four (4) copies oi plans for proposed work • Draw to scale and note the lollowing as applicable: • Property Lines • Centerline ot street • Outline and dimensions of all existing and • Indicate North proposed stiuctures on the lot • Show any proposed grading chunges :+ Existing and proposed utilities • Show measurements PERMITCONDITIONS . 1. All calls for inspection shall be made 24 hrs. in advance - phone 25'9-881 5. 2. All work shall be performed in accordance wilh this permit and current Cily of Everett Design and Constiuction Standards and Spec''ications. 3. Call Location Underground Service 48 hrs. before you dig. TULL FREE NUMBER 1•800•424-5555. %tf�' ��'/G GcJCY,cs f=%�jr�iT� .PFqU%�E'v_ ��% �i�8s" for Construction FINAL INSPECTION Approved as ConsVucted everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98eJi Phone: 259-8815 Date Date ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees t� hold and save harm� less the City of Everett Irom any and all claims for damages, costs, expenses, or causes ol action that may arise because of installation and maintenance ol the improvement or other right-of•way use hereto applied for and further agrees to remove same upon notice from the Cily and to replace public property damaged thereby. Signature ot Applicant Da�e WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PEFMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLET�ON. THIS PERh11T MAY dE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS UURATION.