5021 SOUND AVE 2016-01-01 MF Import

Date��' ( Application For PUBLIC WORKS PERMIT Print or Type Only Describe Proposed Work Proiect Address (if known) 3'!- 29-� Puoi¢ wo�ka Permn . BiEp Oept. • Pubuc Wo�b Fee Total Fce s lessaoo� Fee Paia S Bapnce Due S Y3 3�7-6� Zip P Attach four (4) copies of plans tor proposed worh � �raw to scale and note ihe following as applicable: • Property Lines • Centerline of sireet � Outline and dimensions of all exisling and • Indicate Norih proposed structures on the lot • Show any proposed grading changes • Ezis�ing and proposed utilities • Show measurements PERMIT CONDITION6 1. All calls for fnspection shall be mede 24 hrs. in advance • phone 259•8810. 2. All work shell be peAormed in accordence with this permit and current City of Everett Design and Consiruction Stendards and Specificetions. 3. Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424-5555. � f�.�,� ltJv�/t i`��rw{ �e�u-�u.� ��- -��-� ��'.�'- � � ,�. �'��`` ��,..� �� ,� � irrec✓ lcc�i.�t�''�. � �%u�j„�f U.P.C. �,�,0 .s�u„-� .�� ��. ��'� ��, il� 2"35-9� Approved for Consiruction Date FINAL INSPECTION Date Appraved as Constructed everett PUBL�G WORKS DEPARTMENT � 3200 Cedar Sireet Everett, WA 98207 Phone: 259-BB10 ACKNOWLEDGEMENT OF CONDITIONS W H � � � O � � O a The undersignetl owner/applicanl hereby agrees to hold and save harm- less the Ciry ol Everett from any and all claims lor tlamages, costs, expenses, or causes of action that may arise because ol installation and maintenance of ihe improvement or olher right-ohway use hereto applied tor and turlher ag�ees to remove same upon notice Irom ihe City and lo rep�ace public properry damaged thereby. Signature o� APPlicant Date WORK AUTHUh;�Fn BY THIS PERMIT MUST BE STARTED WiTHIN 180 DAYS OF DATE ?ERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED i0 COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.