3812 28TH PL NE 2016-01-01 MF Import

TYPE OR PRINT ONLY NPWicatior� For PUBLIC WORKS PERMIT PUBLIC WOfiKS DEPARTMENT 3200 Cedar Sireet Everery, WA 98201 259-8810 Mailing Date I(lT zS/q� � Public Works Pertnit N _�� Building Permtt X Public Works Fee $ ��lJ Phone Applicant Mailing AAdress Cit y Z�P Phone Describe Proposed Work _ �z��i PROJECT ADDRESS (if known) UE Attach four (4) copies of plans for proposed work - Draw to scale and note the following if applicable: •Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposetl utilities •Centerline of street •Indicate North •Show any proposed grading changes •Show measurements --�------.. �.��..��.� PERMIT CONDITIONS: 1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. 2. All work shali be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before yo� dig. TOLL FREE NUMBER 1-800-424-5555. �; �rns,on c�n�ral Sha►I be. Pra�;ded As �er-11�e �lan ou�l�;�ul;n Jloy � I��e,� �a �l,a �� ,y d�f.t'd I�oue►., lxt 30� �13Z, i,� �d� iPan, � 5� It �e�cG Pe�r y�n�rr� pl�n �ZoS!► �H�II bG �n yf�ll� s n�a�vrl�� ��w ed�c of -�a 35 f� b�Fcr fv k�w ex;�i n�vt�tki�� , o�y,�,r arvs�oa ca�;�-ol 3b,�ll �x'��s-l�lla�ci.�tc�t�,�f.,� o�{f1�e F�hI�L�Yo�s l h s pc��r. 5. k�� .1 !�''Cl�'is (it�Zi ✓1 G� Z.I � � vtaY� npproved as Constructed �_1-:_'�-9i 11.�'_tn�f h .�a7fjJ ar��n zc.00 r arti� �o.co A OM3�01 W F- �s/� Vl � O � i�.}-i�'r; �O.GO ACKNOWLEDGEMENT OF CONDITIONS The undersigned owneNapplicant hereby a9rees to hold and save harmless the City of rom any and all claims for damages, costs, expenses, or causes o ction t at may arise because ot installation and m2intenance oi theimp vemento otherright-of-wayuseheietoappliedforandfurtheragrees to rem ve same pon notice from the C' and to repiace public p�operty damag d thereb . / .�i Signature of Applicant Date WORK AUTHORIZEC BY THIS PERMII' MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFIER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PER:AIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRQIECT OVER 90 DAYS DURA770N.