506 61ST ST SE 2018-01-02 MF Import

Date-L/,2# re 0* Application For PUBLIC WORKS PERMIT Print or Type Only City Describe Proposed Work Project Address lit knm, n) I Publrt WOA: Permll oms DePI : Public Work: Fee -- Tpl:l Fee i les: AVpt For Paid $ Bel:nce Due $ Attach four (4) copies of plans for proposed work - Draw to scr.lc al.d 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 Phone Phone PERMIT CONDITIONS 1. All calla for inspection shall 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. Cell Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 1-800-424.5565 Approved for Construction ACKNOWLEDGEMENT OF CONDITIONS W �F Im O Z O O a 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 and maintenance of the improvement or other right-ot• way use hereto Date applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. FINAL INSPECTION Dale Approved as Constructed r, PrOt PUBLIC WORKS DEPARTMENT Everett, WA 98201 ve.lPhone: 259.8815 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.