816 52ND ST SE 2016-01-01 MF Import

oate�.t?� 7 � Application For PUBLIC WORKS PERMIT Print or Type Only Describe Proposed Work Prolect Address (if known) Address Meiling _ ��.,,�J Sf � Attach tour (4) copies of plens for proposed work • Draw to scale and note ihe following a:, applicab�e: • property Lines • Outline and d{mensions of all existing and proposed structures on the lot � Existtng and proposed utllities � P�OGc Worke Permi� Y BIOp. DePL a � I 7�i �- Pu�lic Worke Fee s Tolel Fea Lesn ApC� Fea PeiO S Bnlance Due • Centerline of street • Indicate North • Show any proposed grading changes • Show measurements PERMIT CONDITIONS i. All calls tor inspection shell be made 24 hra in advance • phone 259•881 5. 2. All work shall be pertormed in accordance with this permil and current City of Everett Design and Construction Stundards and Specificetions 3. Call Location Underground Service 48 hra before you dig. TOLL FREE NUMBER 1•800-424-5555. ; �G�-G�� z.�-1��u7'` 72e�° Approved for Construction Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259�8815 !/ / / /�g % `��,i� ACKNOWLEDGEMENT OF CONDITIONS W H � � � � O a The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for dameges, costs, expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right•of-way use hereto applied tor and turther agrees lo remove same upon notice from the City and to replace public property damaged thereby. Q�� 1�.�_ /- Z 9 -87 Signature of Applicant Uate WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TFfIS PROJECT OVER 90 DAYS DURATION.