5 W MARILYN AVE 2016-01-01 MF Import

Date 8�25/92 PUBLIC Print or Type Only Appllcation For WORKS 'I� ci �^ i TO P'OSTiNG �21-qs PERMIT ["I y � f Cl �'. I'1 f�..� '.(1 fb •� . r.i �i .:i� c� n. � i in u. r: �- �'� . i t. i Publle Workt Pvmll � � i eiea.oao�.• 37806 Pu01k Work� Fat TOI�tFi� �� ltn Apol F�� PrIE S B\I�M� DW O Richard Kelley b�Y—y�"L4 •� Appllcent Meiling Address Clty Zip Phone Describe Proposed Work PlaCe mobile hoIDe Proiect Addresa (if known) Altech four (4� coDles of plans for proposed work • Drew to scale and note the lollowing as applicable: • Property Lines • Cunterline of street • Outline and dimensiona of all existing and • InAicate North proposed alructures on the lot • Show any proposed grading chenpes • Exlatinq and propaaed utilitlea • Show meesurements PERMIT CONDITIONS 1. All calls for Inapection shall be made 24 hra. In advence - phone 259-8810. 2, All work shall be peAormed fn accordance with thls permit and curtent Ciy of Everett Design and Construction Standerda end SpeciNcationa 3. Call Location Underpround Service 4B hn. before you dig. TOLL FREE NUMBER 1-8i10�424•5555. Approved as Constructed ACKNOWLEDGEMENT OF CONDITIONS W H � � � O � � O a The undersiqned owner/applicant hereby agrees to hold and save harm- less the City of Everell iram any and all claims for damages, costs, �. expensea or causes ot ection thet may arise becauae o1 Installation CI„ ,� 9-2�� and maintenance ot the improvement or other right•of•way use herato �`�� applied for and turther agrees to remove same upon notice from the , _ _ ��_ Date � City and to replace pu6lic properry damaged thereby. ��PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett WA 98201 Phone:259•8810 Signature ol Applicant �d � �J 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 PROJECT OVER 90 DAYS DURATION.