2130 116TH ST SE 2018-01-02 MF Import

Datej1_L3-8 7 Ai vilicalion For PURLIO WORKS PERMIT TO POSTING 7=/Z-93 Print or Type Only Applicant Mailing Address Describe ProposeO WoO Lb nE x� Protect Address fit known) Z 1 --Ic i 1 CO-M ST SCL. Zip P.b"WP,.. Fe. S r.rai F.. -- I.F. AMI Fee FudS Attach lour 14) copies of plane for proposed work • Draw to scale and note the following as applicable. • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements a� �PERMIT CONDITIONS I 1. All calls for Inspection shell be made 24 firs. In advance • phone 259.8810. _ 2. All work shell be performed In accordance with this perms! end current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 fire. before you dig TOLL FREE NUMDER 1.1100-4 4-5555. Approved i Construction 1 Dale FINAL INS .0 10 , Date Approved as Consnucten W PUBIIC WORKS DEPARTMENT 3200.edar Street Everell, NA 98201201 Phone. 259-8810 ACKNOWLEDGEMENT OF CONDITIONS Z O The undersigned owner/applicant hereby agreesto hold and save harm. leas the City of Everett hem an, and all claims for damages, costa expenses. or causes of action that may arlae because of Installation and maintenance of the Improvement or other right•ol-way use hereto applied for and further agrees to remove some 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.