329 60TH ST SE 2016-01-01 MF Import

k Date�3I? � � Public works Permit e Application For eidg.Dept. ; PUBLIC WORKS PERMIT PubTo Works Fee Tc Fee Z< Less App[Fee Paid f{ aeienc!Due S Print or Type Only Owner Mailing Address City Zip Phone Applicant Mailing Address 7 )City Zip Phone Describe Proposed Work Y] W / S - 7 +, i Project Address(If known) --- 2tJ) � I Attach lour(4)copies of plans for proposed work- Draw to scale and note the following as applicable: • Property Lines 0 Centerline of street • 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 DO NOT WRITE BELOW THIS LINE O PERMIT CONDITIONS 1. All calls for inspection shell be made 24 hrs in advance-phone 259.8815. sltrlt+ 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction r� Standards and Specifications. 3. Cell Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1.800.424.5555. z � r lee H 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, costs, expenses, or causes of action that may arise because of installation rand maintenance of the improvement or other right-of-way use hereto t_ applied for and further agrees to remove same upon notice from the ![E Approved for Construction Date City and to replace public property damaged thereby. FINAL INSPECTION Date Approved as Constructed Signature of Applicant Date iiPUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE Phone:259.8815 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.