711 112TH ST SE 7 ELEVEN 2018-01-02 MF Import

Ri Application For yj PUBLIC WORKS PERMITbate September99� PUBLIC WORKS DEPARTMENT -6 Public Works Permit # 97/289 3200 Cedar Street-7 `� Q Everett, WA 98201 259-8810 vfl� U $ ' my Permit # W TYPE OR PRINT ONLY Public Works Fee $ 25.00 Q_ � r William Duesenberg 12350 Northup Way a ?' Bed evue WA 98005 (425) 861-8292 Owner. Mailing Address City Zip Phone Same Applicant Mailing Address " jE Iff City Zip Phone C� r Describe Proposed Work ' Olean up brush and garbage. on property. PROJECT ADDRESS_ (if known) NE corner of 7th Ave SE & 112th ST SE 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 proposed utilities O 'Centerline of street •Indicate North . •Show any proposed grading changes 'Show measurements DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS: 1. All calls for inspection shall be made 24.:hours in advance-- phone 259-8810.. 2.,,Atl work shall be performed in accordance with this permit. and current City of Everett Design and Construction Standards and Specifications.. O 3: Call Location Underground Service 48 hrs: before you dig. TOLL FREE NUMBER 1-800'424-5555. 5. Keep City streets clean at ' 136 r all times. UN 6. Re plant area with grass seed tt� after clearing. i11 N o f 41rd fk_ r�/ Cl.�ared B -Oskad ACKNOWLEDGEMENT OF"CONDITIONS The undersigned owner/applicanthereby agrees to hold and save harmless the City of Everett from any and all claims for damages, costs, expenses, or causes of action that may arise because ofinstallation and maintenance of . the improvement or other right-of-way use hereto applied for and further agrees to remove same upon .notice from the City and to replace public property damaged thereby. Signature of Applicant 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 DAYS DURATION.