2415 TAYLOR DR 2016-01-01 MF Import

rW, Date�B Application For PUBLIC WORKS PERMIT Print or Type Only Describe Proposed Work � Prolec� Address (it kno::n) Address ' City 'l5 -/��iJ. J`C I Adtlress City i A�.._�.�n. .� /':� r�=, -Pu�bc Works Permit � eiae. oeo�.. �l'�'�!�!l �/a3 � Putil¢ Worka Fea s Total Fee Less ApM� Fee Paia S Attach four (4) copies of plans for proposed work - D�aw lo scele and note Ihe tollowing as applicable: • Property Lines • Outline and dimensions of all existing ard proposed structures on the lot • Existing and proposeA utilities Baixnc¢ Due • Centerline of street • Indiwte Norih • Show any proposed grading changes • Show measuremenis PY,one PERMIT CONDITIONS 1. A�I cells for inspection shall be mede 24 hrs. in advance - phone 259•881 O. 2. All work shell be pertormed in accordance with this permit and current City of Everett Design and Construction Standerds and Specificetions. 3. Cell Locetion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424•5555. 4l�'��.�-.� Approved br Con;truction FINAL INSPECTION Approved as Consirucled everett PUBLIC WORKS DEPARTMENT � 3200 Cedar SUeet Everett, WA 98201 Phone:259�8810 Date Date ACKNOWLEDGEMENT OF CONDITIONS W F- � H N O a The undersigned owner/applican� hereUy agrees to hold and save harm- ' less the Cily ol Evere�� Irom any and all claims for damages, costs, � expenses, or causes ol action that may arise because of installation � and maintenance ol ihe improvemenl or other iighPo4way use hereto '� applied lor and further ag�res to remove same upon notice Irom the ' City and to replace public property damaged thereby. �� i Signature ol Applicant Date WORK AUTHORIZED 6Y THIS PERMIT MUST BE STAFTED WITHIN 100 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BV THE CITV UFON ANV STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.