502 WETMORE AVE 2016-01-01 MF Import

Date 3 � Y �F Application For PUB'LIC �"�ORKS PERMIT Print or Type Only � I �, I I l l Owner Mailing Describe Froposed Work � � A .. 1 I V 1 I� Pro�ect Addreas (if known) City City l, � Zip 8y %3 Pu�lic Works Permlt • B�EO� Oepl. • Pubi�¢ Korks Fee s'�� CJ U Totel Fea Lem Rool. fee Pe�� s Beiance Due S �. ��o Phone � S7f� _jll`% Phone Attach lour (4) copies of plens br proVosed work- Draw to scale and note the lollowing as applicable: • Property Lines • Centerline ol street • Outline and dimensions of all ezisting and � Indicate Norih proposed siructures on ihe lol • Show any proposed grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls lor inspection shall be made 24 hrs. in ativance - phone 259-881 5. 2. All work shall be perbrmed in accordance with this permit and current Ciry of Everetl Design and Conslruction Standards end Specifications 3. Call Locatlon Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•555b. i M��' s, � r r� roved for Construction Date ��/T-��- � 8 -A Y FINAL INSPECTION Date Approved as Consiructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259-88 7 5 ACKNOWLEDGEMENT OF CONDITIONS � � J � � O a The undersigned owner/applicant nereby agrees lo hold and save harm- less the City of Everett irom any and all claims tor damages, costs, expenses, or causes ot action �hal may arise 6ecause of installation and maintenance of ihe improvement or other right-oi-�vay use hereto applied for and turiher agrees to remove same upon notice Irom the City and to replace public property damaged ihereby. G� /S �'� Signature of A lican� Date WORK AUi� RIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DAT[ PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLGTION. THIS PERMIT MAV BE CANCELLED BV THE GITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURHTION.