2118 WALNUT ST 2018-01-02 MF Import

`- Pubbe Woil,s Permit • Bag. Dept. a _ Apnhcation For PUBLIC WORKS PERMIT PUE $ Totaall FFeeeeF¢e To Less Appt Fee Paid $ Print or Type Only Balance Due S cZU ve) 795�L� pp Owner ' Mailing Address City Zip Phone Applicant Mailing Address City Zip Phone Describe Proposed Work �y r� /7 %� � It/ C� Project Address (if known) �— e— �IFYC' Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: • Property Lines • Centerline of street • 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 PERMIT CONDITIONS 1. All calls for inspection shall be made 24 firs. in advance - phone 259.881 5. 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 Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. UJ 0 0 ch 0 a 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 7 p �s and maintenance of the Improvement or other Tight -of -way use hereto ✓ 4- ✓ applied for and further agrees to remove same upon notice from the City and to replace public property dam ged thereby. Approved f Construction Date ?TNAnNSPECTIONI. Date Slgna�of Applicant - Date Approved as Constructed WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TOEverett, ie,,erette 3200 Cedar Street BE DILIGENTLY PURSUED 10 COMPLETION. THIS PERMIT MAY BE WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS Phone: 259-885 PROJECT OVER 90 DAYS DURATION.