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

Date �s ift t<c'CEapf omv o.m Application For PUBLIC WORKS PERMIT aaa:°:.`°° LOU Mnt Fee P.aS _ e.i..c. Due S Print or Type Only M04..'TO a ld1laSiV IF-S to Lo - O't ST TOreg.TT - 9 870 33q"Z5 Owner Mailing Address City Zip Phone — Applicant Sjv-NQ Meiling Address City Zip Phone Describe Proposed Work _ '- FILL W sV 1 (<' Y� U j k� Project Address lit known) Attach four(4) copies of plans for proposed work- Draw to scale and note the following as applicable: • Property Lines • Centerline of street 'w co • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements M DO NO7 WRITE BELOW THIS LINE O PERMIT CONDITIONS 1. All calls for Inspection shalt be made 24 his. in advance - phone 259.8815. 2. All work shell be performed in accordance with this permit and current City of Everett Design and Construction 000) Standards and Specifications 3 Call Location Underground Serviee48 his. before you dig. TOLL FREE NUMBER 1.800.424.5555. z /i✓J�R=2 TEE' . I A 6 . /Ito a .r Approve for Constr y Date FINAL INSPECTION Date Approved as Constructed i PUBLIC WORKS DEPARTMENT 3200 Ceder Street Everele tt. WA 98201 Phone', 259-8815 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, cost& expenses, or causes of aclian that may arise because of installation and maintenance of the improvement or other right obWay use hereto applied for and further agrees to remove same upon notice from the City and to replace public property d aged thereby. Signature of Applicant 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.