3903 SMITH AVE 2018-01-01 MF Import

/� /�� ^-r- -�o �.�rr�`-r�1 f� � �i Date—LL�— `Q � l � `v�J Puoeewo��ve�mn ��+ �/� � � �� Applicati0n Fof B�ap Deot.• PUBLIC WORKS P1=RMIT °°°;a„F«`°° : v, �� leu Aool Fae Peia S �S..r.� �� aZ:)_� �—' 9.00a.o�. :�_ ��✓ Print or Type Only � ` � .' � �-��'� �� vti th �1,.� �a ',�r�- �01 Owner Mailing Address City Zip P�one Applicant Mading ACtlress City Zip Phone Describe Proposed Work � 1 !J1�K�d- t �� W Project Atltlress(i1 known) � Atlech four(4)copies ol pians lor proposed work• Draw to scale antl note the tollowing as applicable: � • Property Lines • Centerline ol street � • Outline and dimensions of all ezisting and • Indicate Nort� oroposed structures on Ihe lot • Show any proposed grading changes • Existing and proposetl utililies • Show mPasuremenls � DO NOT WFITE BELOW THIS LINE O PERMIT CONDITIONS 1.All calla lor inspection shall 6e made 24 hrs.in advance-phone 259•$810. � 2.All work shell be peAormed in accordance with this permit a�d curcent City ol Everett Design and Construction Stande�ds and Specifications. 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424•5555. � O � � O a ; � �� � . � ACKNOWLEDGEMENT OF CONDITIONS 1 The undersigned owneUapplicant�ereby agrees to hold and save harm- � less the Ciry ol Everett Irom any and all claims lor damagex costA � �� /�/ expenses. or causes ol action ihat may arisn because ol insialla�ion �O �' �� and mainlenance ol Ihe improvement or other righbol-way use hereto applied lor and lurther agrees to remove same upon notice from the ADProved for n V lon Date Ciry and to replace public property damaged thereby. i� , �G -y'-�y l � �z-X-�� FINAL INSPECTION Date -- qpproveC as Constructed Si at r f Applicant �ate PUBLIC WORKS DEPARTMENi W HOR�ZED DY THIS PERMIT MUST BE STARTED WITHIN everett ^^ 780 DP.YS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO �� ....r�r,,m.��