3014 23RD ST 2018-01-02 MF Import

Date 3/7/g1 C `; Public Works Permea 9/- / 9 APPIIcatioll For \\ Bidp. Dept,a 91/2f,SR7 PUBLIC WORKS PERMIT Pbhc WFee Fee TotalLeas Appt Fee Paid S Print or Type Only Balance Due S ZO c1-& wlp ' 1n14 - 2arA cr- ?W1747 Owner Mailing Address City Zip Phone Applicant Mailing Address City Zip Phone Describe Proposed Work _ Addition -7p COh V C -'f' 4-o Q D V RLe X P!oject Address (if known) 3014 — 23rd St. Attach four (4) copies of plans for proposed work -.Draw to scale and note th • Property Lines • • Outline and dimensions of al! existing and • proposed structures on the lot • • Existing and proposed utilities • DO NOT WRITE BELOW' r'v11 //// n�-� 96 303 1A/ C, tdr�ior S PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance -phone 2. All work shall ba performed in accordance with this permit and cl Standards and Specifications..',/► 3. Call Location Underground Service 48 hrs. before you dig. TOLL 2J• Q Su�t�4ia-<y �/y� ete/�iai XJ a&— 4. 'i+2tvtta✓(Gtn'K.. �p /� CX Q t.�,tfC.UO 7�?r•.i ��.s,..Jt ---A0 Approved fof Construction Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, iNA 98201 Phone: 259-8810 ACKNOWLEDGEMENT OF CONDITIONS 0 z 0 v: O a The -indersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from 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-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. 9-,Ig-gl Si ure of Applicant Date ,WqAK AUTHORIZED BY THIS PE T MUST BE STARTED WITHIN 0 DAYS OF DATE PERMIT IS f. UED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.