6714 WETMORE AVE 2016-01-01 MF Import

Date �8 O � Application For PUBLIC WORKS PERMIT Print or Type Only Owner Address Address Describe Proposud Work �� v �� % Pue��c Works Perpmd� • L--��1'�� — Biap Oepl � �.S'�—�-- Puoim W oae �ee Tolei Fe^ s — Less RDO�� ee Pmd s ---- Balance Due S Z� 0t7 rnone / L�Ja fiaor� i9✓c_ -- Project Address lit known) �� Attach four (4) copies of plans foc proposed work � Draw to scale and note the followiog as applicab�e: • Proparty Lines • Outline antl dimeneions of all existing and proposed structures on Ihe lot • Existing and pr000sed utilities • Centerline ol sheet • Indicate North • Show any propused gradiny changes • Show measurements PERMIT CONDITIONS 1. All cella for inspection shall be made 24 hrs. in advence - phore 259•8610. 2. All work shall be performed in acco�dence with this permil and current City of Everett Design and Constructlon Stenderda end Specifications. 3. Call Location Undarground Service 48 hre. before you dig. TOLL FREE NUMBER 1•600�424•555b. tor Approved as Gonstructetl everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everetl, WA 98201 Phone:259-8B10 / .., ��o — �i, ate _ s -9� Date - 3839 ACKNOWIEDGENENT OF CONDITIONS W H � � � � � � O � � � a The undersigned owner/applicant hereby agrees to hold and save harm- less the City ol Everett hom any and all claims for damages. costa ezpenses, or causes ol action that may arise because of instaitation and maintenance ol the improvement or other right-of�way use hereto applied for and furiher agrees to remove same upon nolice from the Ciry and to replace public p�operry damaged thereby. $i alure of A�Jplicanl � - � WO AUiHORIZED BY THIS PERMIT MUSi BE STPRTED WITHIN 780 AYS OF DATE PERMIT IS I�SUED AND THEREAFTER IS TO �E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE C�NCELLED BY THE CIT" UPON ANY STOPPAGE OF WORK ON THIS nfi(UECT OVER 90 DAYS DURATION.