311 60TH ST SE 2016-01-01 MF Import

Date 1S,I I Pu41�c wbrh.P.rml• �y 17 Z9/ ,Y B-41 pool. Apphc ttion For PUBLIC WORKS PERMIT 1ahs,wo sroe s �oeoo _ Leo♦PPI Fee P&W ^ aelee:e Da. / ; t7r.0 0 Print or Type Only -if ��.G 4� �n rnv Iy �� 5t1i Ave 5rE i vere77 S�La�I 337- foo � �`'' Melling Address City Zip Phone Owner A Svn Applicant Melling Adtlress Clly Zip Phone Describe Proposed Work W Project Address(if known) �T t f Attach lour 141 copies of plane for proposed work- Draw to scala and note the following as applicable. r� • Property Lines Is Centerline of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed Brading changes • Existing and proposed utilities • St aw measurements DO NOT WRITE BELOW THIS LINE O PERMIT CONDITIONS t. Ali cella for Inspection shell be r.iede 24 his. In advance•phone 259-8815 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Underground S 3. Coll Location Underground Service 48 his. before you dig.TOLL FREE NUMBER 1-800-424-5555. , ClrMM M/ AO ACKNOWLEDGEMENT OF CONDITIONS , The undersigned owne.lapplicant hereby agrees to hold and save harm less the City of Everett from any and all claims for damages, costs, expenses, or causes of action that may arise because of installation • s•• ✓ and maintenance of the improvement oother right-of-way use hereto qj , l applied for and further agrees to remove e name uponn notice from the improved for Construction / Dale City and to replace public property damaged thereby. ANAL INSPECTION Date y3 le v Approved as Constructed Signature of Applicant WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN everelt PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE K Everett WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS O Phone:259.8815 PROJECT OVER 9C DAYS DURATION. t r