2930 WETMORE AVE BELL AND INGRAM 2018-01-02 MF Import

Deter 16 Application For PUBLIC WORKS PERMIT Print or Type Only rvrnnn�y rrcuivao ugly P.WIC Works Per I • BIRO JaPI, s f•^ ' NWIC works Fee S rorel Fee Leas l opt Fee Paid S Balance Due f•none Applicant Mailing Address City Zip Phone Project Address (d known) 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 qrading changes • Existing and proposed utilities • Show measurement PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance - phone 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 Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800-424.5555. t�b aL IL woz'�-:. f�Krt I i )'l CDT ir�vC-' Approved for Construction Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT 3200tt,WA Street Everett, WA 98201 Phone: 259.8810 ACKNOWLEDGEMENT OF CONDITIONS W H Cal O The undersigned owner/applicant hereby agrees to hold and gave 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-nf-v By use hereto applied for and further agrees to remove same upon notice from the City and to replace public,, property damaged thereby. Signature or Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTEO WI-i HIN 160 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CI fY UPON ANY STOPPAGE OF WORK ON HIS PROJECT OVER 90 DAYS DURATION.