3119 20TH ST 2016-01-01 MF Import

TYPE OR � � ONLY ' ' Application For PUBLIC WORKS PERMIT Describe Proposed Work PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 259-B810 � Date _ aC� Public Works Permit # � z�/ Building Permit N .__-.— Public Works Fee $ �� ,�- �J A 9 b'ao �sz = i 8 City� Zip � Phone City Zip Phone ' PROJECT ADDRESS (if known) " "' � r�ru.� Attach four (4) copies of plans tor proposed work - Draw to scale and note tha follow�ing if applicable: •Property Lines •Outline and dimensions of all existing and proposed structures on the lot •Existi�g an;1 proposed utilities •Centerline of street •Indicate North •Show any proposed grading changes •Sr �� , iasurements PERMIT CUNDITIONS: 1. All calis for inspection shall be made 24 hours in advance - phone. 259-8810. 2. All work shall be performed in accordance with thr: permit and current City of Everett Desigr and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before yo� dig. TOLL FP.EE NUMBER 1-800-424-5555. tl � ' �N � � O � I a r � 1 \. � -;+ I Approved tor Constru ie� � Date i ) i �� FINAL INSPE�ION � Dat Approved as onstructed W � � V♦ � O � � O i♦A V♦ O a � � ACKNOWLED6EMENTOFCONDITIONS The undersigned owner/applicant hereby agrees to hold and save hartnless ihe City of Everett from any and all claims for damages, cosl;, expenses, or causes of action that may arise b=cause of installation and maintenance of the improvement or olher right-of-way use hereto applied for and further agrees to remove same upon notica lrom the Ciry and !o replace public propedy damaged ihereby. �%if///�//. � / ��il/l�//fA�C 5' nature of Appli,. nt Date WORK AUTHORIZED BY TNIS PERMIT MUST BE STARTED WITHIN 180 �AYS OF DATE PERMIT IS ISSUED AND THERFAF.'ER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON"�IS PROJECT GVER 90 DAYS DURATION.