2224 60TH ST SE 2016-01-01 MF Import

Date. /,' /p Public Works Pil Application For • �/ 6-G/�ypG �ALI�LO Bldg Dept e A fI ��d_ 10-(}=_ '-" lic Works PUBLIC WORKS PERMIT PubTotal FeeFee Lau•PPI Fee Paid • Baiencs Due Print or Type Only 1)� o of aaa -lin s� toA 3��-cr,�ao Owner Melling Address City Zip Phone Pill ' 3 �/r'/1 Applicant Mailing Address Cityy ip Rone Describe Proposed Work �t19,OR5 If /Jn.{�T—�4.'YYl!/ 449 ' --- / !1J Uj Project Address til known) 2 a Q 044 Attach four(4)copies of plans t„r proposed work- Drew to scale and note the following as applicable: tttttt�� • Property Lines • Centerline of street ♦A • Outline and dimensions of all existing and • Indicate North v♦ proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements M DO NOT WRITE BELOW THIS LINE O PERMIT CONDITIONS 1. All cells for inspection shell be made 24 hrs. In advance•phone 259-8815. 2. All work shell be performed In accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 itis.before you dig.TOLL FREE NUMBER 1.800.424.5555. z O O Oise ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, coals, expenses, or causes of action that may arise because of installation and maintenance of the Improvement oother right-of-wayuse hereto yE applied for and further agrees to remove e same uponnnotice from the Approved for Co (ruction (tale Cdend to eplace public propert damaged thereby. FSNALN CTION Date Approved as Constructed Ignetureo p tic nl Dalfe everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS ERMIT MUST BE CTARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS T) 3200 Ceder Street BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK.ON THIS Phone:259.8815 PROJECT OVER 90 DAYS DURATION.