2831 W MARINE VIEW DR 2018-01-02 MF Import

Date1/;1 414-y Application For PUBLIC WORKS PERMIT Print or Type Only Owner ess City Public Works Permit e 7/ Bldg Deft. • �2I.Z 15.3? Public Works Fee Total Fee $ — - Less APO Fee Paid 5 — r!t' Balance Due $ �— _ S m jii - - Applicant Mailing Address City Zip Phone Describe Proposed Work UJ Project Address lit known) )�� Vy /xl-6�LtJ OX , -- Attach lour )4) copies of plans for proposed work - Draw to scale and note the following as applicable: • Property Lines • Centerline of street /A • Outline and dimensions of all existing and • Indicate North V proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements /N DO NOT WRITE BELOW THIS LINE O PERMIT CONDITIONS 1. All calls for inspection shall be made 24 firs, in advance - phone 259.8810. 2. All work shall be performed in accordance with this permit and current City o.` Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800-424-5555. �e r. G�%bi�� ' den -re �� 1�• L O a-& 9 Q L. ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant 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 use hereto applied for and further agrees to rer..:a same upon notice from the Approved for Corfst ctio� Date City and replace Pubr roPerly damaged thereby. FINAL INSPECTION Date / Approved as Constructed ffignture ApplicantDale HORIZED BY THIS PERMIT MUST BE STARTED WITHIN P,IBLIC WORKS DEPARTMENT OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO 32lnl Cedar Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE Everett, WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS Phone: 259.8810 PROJECT OVER 90 DAYS DURATION.