2003 32ND ST 2016-01-01 MF Import

-,/� � . ;� --� .; Date 7 � � / � Application For PUBLIC WORKS PERMIT Print or Type Only Owner -. Public Worke Permil • B�tlg. Oev�. < �� / � / � a�m��wo�ksFaa s Total Fee Less Appt Fea Peia S Balance oue S s a�-7a �d Applicenl Describe Proposed Work Prolect Address (if known) Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: � Property Lines • Centerline of street • Outline and dimensions of all existing and 11 Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls for inspection sliall be made 24 hrs. in advanca • phone 259-881 5. 2. All work shall be pertormed in accordance with this permit and currenl City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424-5555. �!/i3� �G I�C/�/.'/<. ,f f�F i�: T ir/Oi .P� C��ii�� .I _;�f,/ ,� �//BG � Approved for Construction Date FINAL �NSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 ACKNOWLEDGEMENT OF CONDITIONS W H � � O � � O a The undersigned owner/applicant hereby agrees to hold and save harm- less the Ciry ot Everett irom any and all claims for damages, costs, expenses, or causes of action that may arise because of installation and maintenance of ihe improvement or other right-of�way use hereto 3pulied lor end further agrees to remove same upon notice from the Cily and to replace public property damaged thereby. Signature of Applicant Date bVORK AUTHORIZED BY THIS PERMIT MUS7 BE STARTED WITFiIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERt.41T MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.