9826 7TH AVE SE 2016-01-01 MF Import

Date� 0� Application For PUBLIG WORKS PERMIT Print or Type Only Applicant Mailing �� Describe Proposed Work �1 ��.�� ✓ }�1 � Project Address �if known) 1 T�Cl� . ' y IPu�Lc Works Permil • — BiaB� Dept.+ Publ�< Wo�ks Fee Talal Fea S Less An01. Fee Pa'i6 S Balance Oue S City Zip phone Attach tour (4) copies of plans lor proposed work • Draw to scale and note the following as applicable: • Property Lines • Outline and dimensions of all existing and proposed structures on the lot • Existing and proposed utilities r Centerline of street • Indicate North • Show any proposed grading changes • Show measurements Phone PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance- plicne 259•881 Q. 2. A�I work shall be performed in acwrdance with this permit and current Ciry o( Everelt Design and Construction Standards and Specifications. 3. Call Location Un�ierground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424-5555. Approved fcr Construction FIyqLINSPECTION Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259-8810 nt�r �c�u� � ��%8 � �i , ACKNOWLEDGEMENT OF CONDITIONS W � � Z! Oi �� O�'� a The undersigned owner/applicant here6y ayrees to hold and save harm� tess the City of Everett irom any ar.d all claims (or damages, costs, expenses, or causes ot action ihat may arise because of installation and maintenance of the improvement or olher ric�ht-of•way use hereto applied lor and turiher agrees to remove same upon nc:ice from the Da�e City and to replace public property damaged ihereby. Date Signature of ApGlicant Uate WORK AUTHORIZEI? BY THIS PERMIT MUST BE STARTED WITHIN 180 DAY6 OF DATE Pc'RMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STO°PAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.