1024 WOODLAWN AVE 2016-01-01 MF Import

Date� � Application For PUBLIC WORKS PERMIT Print or Type Only d- Adtlress MBIIIOtJ Atltlf055 Describe Proposed Work Pwject Adtlress (ii known) Cily a�nxc wa,xs a�,mn p. eiae oco�.• o L� G2� PueLc Woas Fee Total Fcc s Less Appl Fee PeiO $ Balance Doo S ZiP Phone Attach four (4) copies ol plans lor proposed work - Draw to scale and nole the lollowing as applicable: • Property Lines • Outline and dimensions of all existing and propased slructures on the lot • Exrsting and proposed utilities • Centerline ot street • Indicate Norih • Show any proposed grading changes • Show measurements PERMIT CONDITIONS 1. All calls for inspection sh�!I be made 24 hrs. in adv�nce - phone 259-8810. 2. All work shall be perfornea in accordance with this permit and currenl City ol Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424-5555. ��E%�� /(/c9.� i'��v1�1-�'-C/� Approved lor Construction Oatc FINAL INSPECTION Dale Appro��ed as Constructed everelt PU6LIC WORKS DEPARTMENT � 3200 Cedar Street Evere�t, WA 98201 Phone:259�BB10 `/��'_" 0 /C) "'G lJ —� B ACKNCWLEDGEMENT OF CONDITIONS W H � � O � � O a The undersic�ned o�rner/applicaN hereby agrees to hold and save harm- less the Ciry ol Everett Irom any aud all claims for damages, costs. expenses. or causes ol action Ihat may arise because of inslallafion and maintenance ot the improvemen� or other righ�-obway use herelo applied lor ano lurther agrees to remove same upon notice Irom the Ci�y and to replace public property damaged thereby. of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERM17IT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.