3308 56TH ST SW 2016-01-01 MF Import

Date_�� AUP�ication For PUBLIC WORKS ,��RMIT Print or Type Only Public Warks Permi� s `—' L —��O e�eg. oop�. s P�blic Works Fee s Tolal Fee Le9s ApP� Fae Paitl $ � Balance Due S 2O � Ciry ZiP Describe Proposed Y�ork _1�C�� ' �� Proiect Address (il known) 3.�� S� ��% —' Attach tour (4) copies of plans for proposed work - Draw to :�cale and note lhe'ollowing as applicable: i Property Lines • Outline and dimensions of all existing and propased structures on the lot • Existing and propoaed utilities A� ^ ....0 ��• � �� • Centerline of street • IndicatR North • Show.;ny proposed gr�ding changes • Show measurements PERMIT CO`!DITIONS 1. All calis For inspection shal� be made 24 hrs. in advance � ohone 259•881 5. 2. All work shail be performed in accordance with this pernd: and current City of Everatt Design and Conshuction Standerds and Specifications. 3. Cell Location Underground Service 48 hrs. betore you dig. TOLL FREE NUMBER 1•800•424•5555. pprbv�d as Consiructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 � ��j � Date AGKNOWLEDGEti;rNT OF CONDITIONS W H � � � � � � O a The undersigned owner/applicant here6y agrees to hold and save harm- less lhe City of Everatt irom any and all claims tor damages, costs, expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-oFway use hareto applied for and further agrees to remove same upon notice Irom ihe City a o rr. lace public proPert� namaged thereby. / % � J i ry ! %C .b"�, � 1 . , /'-1 lc..t � %i�/ C� 6ig�f�'ure of ApplicanY Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND TI��EREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. TF�IS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DUPATION.