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Date �� <br />_ - Application For <br />PUBLlC WORKS PERMI', <br />Print or Type Only <br />Addres; <br />� 7-33 2 <br />Pu01it Works Parmit + - <br />eiaq. oeo��+ gg 5 5 <br />Pu01ic Worb Fee s <br />Total Fee <br />LessApO� Fee Paitl S �O �a <br />Baience Due S __ <br />�1[T " P Phone <br />Applir,ant Mailing Address ���Y Z�P <br />Describe Proposed Work <br />Project Address (if known) 320� � �� �' <br />Attech four (4) copies of plans tor proposed work - Draw to scale and note ihe following as applicable: <br />• Property Lines <br />• Outline and dimensions of all exisling and <br />pr000sed structures on the lot <br />• Existing and proposed utilities <br />• CeMedine o' street <br />• Indicate Nonn <br />• Show any prop�sed grading changee. <br />• Shuw measurements <br />P. 9MIT CONDITIONS <br />7. All calls tor inspection shall be made 24 hrs. in edvance • phone 259•881 5. . <br />2. All work shall be pertor.med in accordance with this permil and current City of Everett Design and Construction <br />Stan��ards antl Specifications. <br />3. Call Location Undergraund Service 48 hrs. before ycu dig. TULL FREE NUMBER 1-800•424•5555. <br />I!�STALL NEW PRIVEWA� PER CITY SmAND, �307 .REMOVE 5IDEWALK�CURB <br />AND GUTTEF. COMPLETEL): �PFR SECTI('N 3.3.7 OF THE CITY STANDARDS. <br />� % <br />� <br />tor <br />�` <br />�ate <br />Approved as Gonstructetl <br />everet[ PUBLIC WQRKS DFPp.RTMENT <br />� 3200 Cedar Street <br />Everett. WA 98201 <br />Phone: 259-8815 <br />.4CKNOWLEDGEMENT OF CONDITIONS <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, costs, <br />expenses, or causes of action that may arise because nf installation <br />an� maintenance of the ���nprovement or othe� righFof-waY use hereto <br />applied for and fuAhei ayrees to remove seme upon notice from the <br />Ciry and tQreplace public �Dperty damage�s h�ereb� <br />W¢Fii�UTHORI2ED B�THIS PERMI'i MUST EIE .STARTED WITHIN <br />t�A�bAYS OF DATE pERMIT IS ISSUED AND 'iHE�EAFTEF IS TO <br />�E DILIGENTLY PURSUED TO COMPLETION. TH!S PeRMI" MAY BE <br />CANCELLED BY THE CI'fY UPON ANY STO?PAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />