7121 YEW ST 2016-01-01 MF Import

� ,_ r y .:,. � _ I Puobc Wo�ks Permit • � '�/� ` Application For eiaa oso�� }�d- PUBLIC WORKS PERM�T t� eosTiNG.��- Print or Type Only MaiNng l Pu�im Worhs Fea s Tote� �ee LeasADG� FeeVe�O s BHence Due s � V ^ qpplicant Mailing Address City Lp Phone \ Describe Proposed Work � � � Proiect Address lif known) Attech four (4) copies of Plans for proposed work • Draw to scale and note the tollowing as applicable: • Property Lines • Centerline of street • qutline and dimenaions ol all exist+ng and • Indicate North proposed structures on the lot • Show any proposed grading chenges • Existing and proposed utilities • Show measurements PEqM1T CONDITIONS 1. Atl cells lor Inspection ahell be mede 24 hra in advence • phone 259•8810. 2. All work shall G pNlomrod,fn eccatda�.WltG,ih�formit end cuneM City ol Everett Desip�end Conatructlon StenCerdeerW9ps��katf6na' ` ' ` 3. Call Locetlon UAderpround Sarvice 48 hrs. before you dig. TOLL FREE NUMBER 1-800�4?4555i � \ M -P �Qrn�� io- �G-� Approved for Construction Date FINAL INSPECTIGN Date Approved es Coostructed evere[t PUBUC WORKS OEPARTMENT � 3200 Cedar Stree� Everett, WA 98201 Phone:259•8810 ACKNOWLEDGEMENT OF CONDITIONS W H � � � O � � O a The undersigned owner/applicant hereby egreea to hold and save herm• less the City ol Everett Irom any and all clalms lor damegea costs, ezpenses, or causes of action Ihat may arise because ot installation and maintena�ce of the improvemenl or other right•of-wey use hereto applied tor and further agrees to remove sama upon notice irom ihe City and to replace public property damaged thereby. ��l�i .z��-�� /�- � � S�ignafu e ol App icant Date WORK AUTHORIZED BY THIS PEFMIT 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 CIiY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.