3806 WETMORE AVE 2016-01-01 MF Import

Dale�Q � � Apptication For PUBLIC WORKS PERMIT Print or Type Only Mamng Describe Proposed Work Project Address (il known) Z Zip ��,�,�wo,"Pa,m��. f�8-3y3_ Biap Oev� • �X� Pu�bc Workf Fea ,o�w� Fea S -- Less Aov�. Fee Pe�a $ �/�llO�— BalanceDua S r✓— rnone Atlach fow (4� copies ol plans for proPosed work � Draw to scale and no�e Ihe lollow�ng as applicable: • Properry Lines • Outline and dimensions of all existing and oroposed structures on the lot • �"xisting and proposed utilities , tk • Genterline of stir.et • Indica�e North • Show any proposed qradmg changes • Show measuremenis PERMIT CONDITIONS 1. All calls tor inspection shall be made 24 hrs. in advance • phone 259•8810. 2. All work shall be performed in accordance with this permit and current Gity ol Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800•424•5555. �„i�.,,�/� oa-��- 8-/9-h'8 Approved lor Construc�ior�/f Date ��`�j �—O� �•�/ _ FINAL INS�PECTION Date Approved as Constructed everett PUBLIG WORKS DEPARTMEN7 � 3200 Cedar Street Everett. WA 98201 Phone:259�8810 ACKNOWLEDGEMENT OF CONDITIONS � O � � O a The undersigned owner/applicant hereby agrees to hold and save harm- less Ihe City of Everett Irom any and all claims lor damages, r.osls. eapenses. er causes �� action that may arise �ecause of inslallalion and maintenance of the improvement or olher right-of�way use heretu applied for and lurther agrees to remove same upon notire irom ihe City and to replace publiqproperty damaged thereby. ure VSGRK AUTHOQZED BY THIS PERMIT MUST BE STARTEU WIiHIN 180 DHYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUEf' TO GOMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAVS DURATION.