3000 TERMINAL AVE 2016-01-01 MF Import

i VuEhc Wo4�Permh� 3 /3�/ Date�; . _;,.c:..._ Applicetion For PUBLIC WORKS PERMIT `°°TOWFe"° _ �en�oni.Fee asm f 3S O° e.�.�oe oue • — Print or Type Only �,p�_3zZ yo/ 78�/ Port of Evetett PO Box 538 Everett WA 98206 259-3164 Owner MaiNng Atldress City ZiP Phone Dunlap Towing Co PO Box 593 LaConner 96257 466-3114 Kenny Coonc page 428-5153 AppGcant Meiling Address City Zip Phone Describe Proposed Work inetall oil/vater separater 6 vaeh area for cleaning equipment to be eerviced. 3n�� - W ' Proiect Address�if known) ��Teiminal Ave � � Attach four(4)copiea ol plans for propoeed work•Draw to scale antl note tne to�lowing as appliceble: � • Property Lines • Centerline of street � Outline and dimensions ol ell exiating anA • Indicete North proposeC alructu�es on the tol • Show an:propoaed gredinq change6 - • Exitling and proposed utilities • Show measuremente M W �� O NOT WRITE ELOW MIS LINE O � PERMITCONDITIONS � 1.All c�Ms for Inspectlon�M�I be m�de 24 hro.�n advance•phone 280�8/0. - 2.All work ih�ll be peAomrod i^eccordance with thle permit and current City of Everetl Deelqn end Conalrudlon Shndard��nd SpecHlcatlona. � 3.GII Loc�tfon Undsrpro�nd 3erviq 4B hn.bafore you dip.TOIL Fl1EE NUMBEIII-800�124�6655. � �i � I � O Q ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby egreea to hold end seve harm- less the City of Everett lrom any and all cleims for Aamagea, costs. expenses, or c�uses of ection thel may erise beceuee of installetion �e/�� _�� _ y,3 and maintenence of the improvement or other riqht•o4wey use herelo � epplied for end further agrees to remove same upon notice from the � Approved or Con truction Date City and to replace public properry damagad thereby. �� — r-Y.�r , a - FINAL INSPECTION Dete Dete Approved es Constructed Signature ol Applic WORK AUTHORIZED BY THIS PE IT MUST BE STAR?ED WI . � PUBLICWONKSDEPARTMENT 1i30 DAYS OF OATE PERMIT I:� ISSUED AND THEREAFTER IS TO 3200CedarStreat BE DI�.�GENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE Everott,WA 88201 CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS Phone:259•8810 PfiOJECT OVE�i 90 DAYS DURATION.