8823 9TH AVE SE 2016-01-01 MF Import

Application For PUBLI � WORKS PERMIT Print or Type Only f� Address Applicant Describe Proposed Work c I� I �� ,� / ��. City Publm Works Pcrmil a ..�_ � !.� Bltlg. Oept t {- PoblicWorksFee 5 Tmal Fee Less Acp� Feo PaiO S Balance Due S Proiect Address (if known) _L'S� � — � �-`�'�- Attach four (4) copies ot plans for proposed work - Graw to scale and note the following as applicable� s Property Lines ,• Centerline of sheet • Outline and dimensions of all existing and • Indicate North proposed strucl�ires on the lot e Show any proposed grading changes • Existing and proposed utilities • Show measurements ne rnone PERMIT COMDITIONS t. All calls for insGection shall be made 24 h�s. in advance - phone 259•881 5. 2. All work shall be perfurmed in accordance with this permit and current Ciry of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLI FREE NUMBER 1•800-424•5555. lC �`��,�'!-� - l��l /_ '/l,�i % � c _-s�:iC. - �z:,r- /�r�;.z Fl> Approved for Construction Date FINAL INSPECTION Date Approved as Construc�ed evereet PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Evoretl. WA 98201 Phone: 259-b815 J� �?�"! •�,�� 'J ACKNOWLEDGEMFNT OF CONDITIONS W � �w � / � O The undersigned owner/applicant liereby a�rees to hold and save harm- less the City of Everett irom any and all claims for damages, costs, expenses, or causes ol action that may arise because of installation and mainlenance of the improvemenl or olher right-of-way use nereto applied tor and further agrees to remove same upon notice trom the City and to replace public property damaged ihereby. naWre of Ppplicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED 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 �AVS DURATION.