3306 WETMORE AVE 2016-01-01 MF Import

Date %�� Application For PUBLIC WORKS PERMIT Print ar Type Only /�- 4 Puobc Won_s Perm�t • / �/ � eieu oeo�- • '� Pu�Lc Works Foe s ,o,a� F« Lesf AnPI Fe±Pq�C s Baience Oue s � ,� Describe ProPosed Work /v F � �� Proiect Address lif known) - '"-'-"��— -�- Atlach tour (4) copies ot plans for proposed work - Draw to scale and note ihe following as epplicable: • Property Lines • Outline and dimensions ot all existing and proposed strudures on the lot • Ezisting and proposed utilities • Centerline of street • Indicate North • Show any proposed grading changes • Show measuremeMs PERMIT CONDITIONS I. All calis for inspeclion shall be made 24 hrs. in advance - phone 259•881 5. 2. All v.�ork shall be pertormed in accordance with this permit and current Ciry ol Everett Design and Construction Standards and Spccilications. 3. Call Location Underground Service 4B hrs. belore you dig. TOL1. FREE NUMBER� •800•424•555 . / � i / � L�, �J-; ci-/��° i�^�-^t C�� /l.-n- �t ,e �z. 7 y��.3 / Approvetl as eons�ruc�eu everett PUBLIC �b'GRKS DEPARTM�NT � 3200 CeAar Street Everett. WA 9020t Phone�. "<59�8815 AGKNObvLEDGEMENT OF COhDIT10N5 � O � N O a The unde�s�gned owner/applicant hereby agrees to hold and save harm� Ir.ss ihe Ciry of Evorett Irom any and all claims for damages, costs. eapen[es, or causes o� action �hal may arise because ol installal�on and maintenance of ihe improvement or olher right-of-way use hereto applied r d turther agrees to remove same upon notice irom ihe City d to re lace public rop ty amaged thereby. �'�� " z / � �'3 Signature ol ApGlicant Dale 80RG YSTOFO DATE� PERMIT ISESISUED AND THEREAFT�ER ISHTO BE DILIGENTLY PUR�UED TO COMPLETION. THIS PEFiMIT fdAY BE C�NC[Ll[D BY TH[ CITY UPON ANY STOPPAGE OF WORK ON THIS I'RGJECT OVER 90 D�YS DUNATIOIJ. 4 � � r-� r- y •- �� �� F O� � �. O� �� � �: �: �+ . �r "O] ; �4 r �t �� �