4434 SEAHURST AVE 2018-01-02 MF Import

Public Hate ( • • Dept Permit Bldg Btop Deot0 Application For PUBLIC WORKS PERMIT PUETotal Fee Fee Total Fee s Lau eoPI Fee Peio i -- Balance Due s Print or Type Only / A�(' V�1anJ `gL/3Y \�cr�1�IcJT �—r/c�c�i I %a_�3 Owner Mailing Address Gty Zip Phone /-957 Ch; (brims hi7- Je1<1 rf,J 3C Applicant ,./Mailing AddressC. Zip Phone Describe ProPoned Work �" `� / X , / - 9-P (d/e OC7I� / 13 A�/v 1-/— UJ Project Address (if known) Attach four (4) copies of plans for proposed work -Draw to scale and note the following as applicable: • Properly 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 M DO NOT WRITE BELOW THIS LINE O PERMIT CONDITIONS 1. All calls for inspection shall be made 24 his. in advance - phone 259.8815. fill 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 his. before you dig. TOLL FREE NUMBER 1-800.424.5555. z ` O s � O 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-ol-way Use hereto applied for and further agrees to remove same upon notice from the Approved for ConF,ruct ion Date City and to replace public property damaged thereby. FINAL INSPECTION Date Approved as Constructed W PUBLIC WORKS DEPARTMENT EverCedar Street Everett, WA 98201 Phone. 259-8815 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.