1013 51ST PL SW 2016-01-01 MF Import

Date 3 ��'Fj� / Applic�.tion For PUBLIC W01'�KS PERMIT Print or Type Only Public Works Petmii • " � ` eiey. oao� • Publit Worka Fee s'��0� ('J O Totel Fee Less A00� Fee PeiO S eaiance Due S ��(). O O �i8�✓`.6 � Address Lescribe Proposed Work Pro)ect Address (H known) Attech four (4) copies ot plans for proposed work • Draw to scale and note the following .35 applicahle: • Praperty Lines • Outline and dimensions of all existing and proposed structures on the lot • Existing end proposed utilities • Centerline of street � indicate NoAh • Show any proposed grading changes � Show measurements PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance - phone 259•881 5. 2. All work ahell be peAormed in accordance with this permil and current City of Everett Design and Construction Standerds and Specificationa 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800'424-5555. �-ru c�c vy� k s-}- b e �-.a,s e vKP� o�lnti� -��.��-�- 3-�-�� ApRroved for Construction Date �� S �-8y FIN INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone:259•8815 Clta.r a � wv s -�- I c�� =, l,�- s,d� a � ld� ACKNOWLEDGEMENT OF CONDITIONS � O � � O a The undersigned owner/applicant hereby agrees to hold and save harm• less ihe City of Everett irom any and all claims for damages, costs, expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-ohway use hereto applied for and turther agrees to remove same upon notice from the Cily and to replace public property damaged thereby. .,�y.......... _...� �-_... v WORK �.JTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEfiEAFTER IS TO BE DILIGENTIY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURAT�ON.