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Date y-2N—Q7 <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Mailing <br />Describe Proposed Work <br />Public'Norks Pormit s 87_ 333 <br />eiag.000��+ �'� <br />Pu01ic Works Fee <br />Totol fae $ — <br />Less ApP� Fee Pai� S_ <br />Belnnce Due S ��O <br />Project Address (if kr,uwn) �: �27` � Sii � .Sf .SW _ <br />Attach four (4) copies of plens for proposed work - Draw to scaie and note the following as applicable: <br />• Property Lines <br />• Outline and dimensions of all exis!ing and <br />proposed structuras on the lot <br />• Existing and proposed utilities <br />PERMIT CONDITIONS <br />• Centerline !( street <br />• Indicate North <br />� ShoH� any aroposed grading changes <br />� Show measurements <br />1. All calls for ins�ction shall be made 24 hrs in advance - phone 259•8815. <br />2. A!I work shell be peAormed ir accordance with this permit and wrrent Cit� of Everett Design and Gonstruction <br />Standards and Spec'fications. <br />3. Cal! Lucation UnderSround Service 4B hrs. before you dig. TOLL FREE N4MBER 1-800-424-5555. <br />INSTALL NFS9 L�RIVEWAY PER CITY. STAND. �307 ,REMOVE SIDEWALK�CURB <br />AND GUT7.'ER COMPL?TELY �PER SL'CTION 3.3.7 OF THE CITY STANDARDS. <br />Approved as <br />everett <br />e <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sireet <br />Everetl, WA 98201 <br />Phone• 259-8815 <br />ACKNOWLEUGFMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the Ciry N Everelt from any and all ciaims for damages, costs, <br />n,xpenses, or causes of action that may ari�e because of installation <br />and maintenance of ths improvement or ��iher righhof-way use hereto <br />applied for and further agrees to remo-.e seme upon noticr from tbe <br />City and to repl�lic property damag ei by. , <br />8( ureOfApp' nt /�VD t�/ <br />RK AUTHO BY THIS PERM�T MUST BE STAfi7ED ITHIF7 <br />8� DAYS OF TE PERMIT IS ISSUED AND THEREAFTER IS TG' <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS FERMIT MAY BE <br />CANCELLED BY TfiE CITY UPON ANl' STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />