1509 WALL ST 2016-01-01 MF Import

Date Application For PUBLIC WORKS PERMIT Print or Type Only Puelic worts PmmM1 . eiao� oen�.• — Pu01�t\VorxaFee s Total Fee Lest A00� Fee PaiO S Balence Oua S Owner Mailing Address City Zip Phone Appiicant Maiiing Address City Zip Phone Describe Proposed Work Project Address (if known) Attach four (4) copies of plans for proposed work • Drew to scale and note Ihe tollowing as applicable: � Property Lines • Centerline of street • Outline and dimensions of ail existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls for inspection shall be mede 24 hrs. in advance • phr�e 259•8810. 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Undergrou�d Service 48 hrs. before you dig. TOLL FREE NUMBER 1-BUO•424•5555. PUBLIC INORKS PERMIT NOT REpUIRED BY DATE Z ZU y7 Approved lor Construction Date FINAL INSPECTION Date Approved as Consiructed �A��PUBLICWORKSDEPARTMENT 3200 CeCar Street Everet4 WA 9B201 Phone: 259�8010 ACKNOWLEUGEMENT OF CONDITIONS W H � � The undersiqned owner/applicant hereby agrees to ho�d and save iiarm• less lhe Cily ol Everett Irom any and all claims tor damages, cosis. eapenses, or causes oi action that may arise because of installation and maintenance ol ihe improvemenl or olher righroFway use hereto applied lor znd turther agrees to remove same upon notice Irom the City and to replace public property damaged thereby. Signature ol Applicant "�" WOFK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO B[ DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVEF 90 DAYS DURATION.