2502 ROCKEFELLER AVE 2016-01-01 MF Import

� oace�ld..�d y Applicatlon For PUBLIC WORKS PERMIT Print or Type Only Melling Meiling Address Deacribe P�oposed Work Project Address lit known) �, Pu�lic Wo�ke Parmit • -- Bltlp� Dept • � PuElit Wo�ha Fee Tolal Fee Laea rlppl Fee PeiE S Balanca Oue Atlech tour (4) copies of plans for proposed work- Draw to scale and note the following as applicable: • Proparty Lines .• Centerline of streel • Outline end dimensions of all existfng and • Indicate North proposed slructures on the lot • Show any proposed grading cha�.ges • Exisling end proposed utiliHes • Show measurements PERMIT CONDITIONS 1. All cells lor inspeclion shall be made 24 h�s. in advance • phone 259•8Ff 15. 2. All work shall be pertormad in accordance N:ih this permit and current City of Everetl Design and Construction Standards and Specificalions 3. Call Locetion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. PUSG�C : <.�.�,�s :�F�.��,- iC./OT �'Fc9Ui.cF�� Approved for Consiruction Date FINAL INSPECTION Date ApProved as Constructed everett PUBLIC WORKS DEPARTN�NT � 3200 Cedar Street Everett, WA 3820 � Phone: 259-8815 s�s�� �� ACKNOWLEDGEMENT OF CONDITIOkS W � � � � O � � O a The undersigned owner/applicant hereby agree: to hoid and save harm• less the City of Everett Irom any and al� claims `or dameges, costa expenses, or causes oi action that may arise because of instellation and maintenance of the improvement or olher right-of•way use heretc applied for and turther agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STAFTED WITHIN 180 UAYS OF DATE PERMIT IS ISSUFD AND Th!ERE.4FTE_R IS TO BE DILIGENTLY PURSUED 70 COMFLFTION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.