1415 122ND ST SE 2018-01-02 MF Import

08t@fib �"N r k I Punic Works Parma a ✓� `v Applicallon For PUBLIC WORKS PERMIT Print or Type Only Bldg Dept a Public Work, Fee Tolal fee S LessAppt Fee Paid S Balance Due 8 ')o to -t Applicant /) Mg Address City t� Zip Phone Describe Proposed Werk � r tlJ�P fJ v Y Pl;[Jow C �_an t E ULa.- Ln, o i o mine e. Project Address (if known) Attach four (4) copies of plans for proposed work - Drew 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 PERMIT CONDITIONS 1. All calls for Inspection shall be made 24 hr& in advance - phone 259.881 5. 2. All work shall be performed in accordence with this permit and current City of Everett Design and Construction Standards end Specifications. 3. Ccll Location Underground Service 48 his. before you dig. TOLL FREE NUMBER 1.800.424.5555. 1" 71�.117- -Zlx� 5�00ar-r 72o _ ^��> 8. Approved for Conslrucll n ate FINAL INSPECTION Date Approved as Constructed everett PURL IC WORKS DEPARTMENT Ever Ceder Street Everett, WA 982018201 Phone: 259.8815 z >,oyc✓ELG S ACKNOWLEDGEMENT OF CONDITIONS W H 0 z 0 0 a The undersigned owner/applicart hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, costa, expenses, or causes of action that may arise because of inatallal-;.i and maintenance of the Improvement or other right-of-way Us. iereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant ate 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 WOPK ON THIS PROJECT OVER 90 DAYS DURATION.