7010 YEW ST 2016-01-01 MF Import

Date_LLC� �'- , S�- 7 �9 �- Application for PUBLIC WORKS PERMIT Print or Type Only PunLCWorksPer � `��!' � emp oew • �� worws Fee �ani Fee S Less Anpl Fer pr�d 5-- eP�a��e o�a t �___ Describe Pioposed Work Project ACtl�ess (ii known� ..._.....�....,..�.,� Gily Zip Pn��e Atlach lour (4) copies ol plans for proposed work Dra ��cale and note ihe following as applicable: • Property Lines • Cenfedine of street • Outline and dlmensions ol a�l existinq and • Indicate North proposetl structures on the Iot • Show an • Existing and proposed utilities Y proposetl g�ading changes • Show measuremenfs PERMIT CONDITIONS 1. All cella for inspection ahall be made 24 hrs. in advance • phone 259�8$10. 2. All work shell be performed in eccordence with this permit end current City of Everett Design and Construction Stentlarde and Speci(icetions. 3. Call Location Underground Service 4B hrs. before you dig. TOLL FREE NUMBER 1•$00�4Q4•SSSS. �, �u d �� - 1 a�� l l i � k��. Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200CedarStreet Everett. WA 9A2o1 Phene: 259-8870 � W � � � �� � ACKNOWLEDGEMEi:' pF CONDITIONS The undersignetl owner/applicant he�eby aqrees to hold and save harm- less ihe City ot EvereU Irom any and all claims for damages, cosis, expenses, or causes o� action that may arise because ol instailatior� and maintenance of the improvement or other right•ol�way use hereto applied lor and lurther agrees to remove same upon notice trom ihe Ciry and to replace public preperty damaged Ihereby. /� y7 (, ry!�,-L% / "Ci'f /� l6 ��'�.�j 'D�% �pnaiure o� Appbcant ' pa�i WORK AUTNOR12ED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT 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 DAVS DURATION.