2308 TAYLOR DR 2016-01-01 MF Import

• � ' . ' '� Application For PUBLIC WORKS PERMIT Print or Type Only Describe Proposed Work Project Address (if known) Mailing Atltlress J �C�J l,! v�-s-V Mailing Address -- ��r� �.�.� City Ciry, PuCLc Worka Permil emq oeo�- • / � vueuc Wo�b Fee S Tolal Fae Lesa Rppl Fee Paitl s Belance Due Attach four (4) copies o1 plans for proposed work • Draw lo scale and note the lollowing as applicable: • Property Lines • Centerline of street • Outline and dimensions ot all existing and • Indicate Norih proposed siructures on ihe lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements �� =�-�a� Phone .33 ; Phone PERMIT CONDITIONS 1. All calls lor inspection shall be made 24 hrs. in advance • phone 259•88� $. 2. All work shall be pertorned in accordance with this permit and current City ol Everet� Design and Construction Standards and Specifications. 3. Call Loca�ion Underground Service 4B hrs. belore you dig. TOLL FREE NUMBER 1•800•424•5555. ��7t/L �i'c�C'�� .�;n? . ,.,�>i ;LG'��:. ,?t=�L� �_ � = ' ' Approved for Construction Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 ACKNOWLE�GEMENT OF CONDITIONS W H � � � O � � O a The undersigned owner/applicant hereby agrees to hold and save harm• less ihe City ol Everett Irom any and all claims for Camages, costs, expenses, or causes of action that may arise because of ins�allati�n and maintenance of the improvement or other right-ol•way use hereto applied for and turiher agrees lo r� �nove same upon notice Irom the City and to replace public property odmaged thereoy. SiQnature ol Applicant Dale WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSU[D 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.