1424 63RD ST SE 2018-01-02 MF Import

D� to _TTUO Application I „, PUBLIC WORKS PERMIT Print or Type Only Add mailing Address Glly Zip Describe Proposed Work Bldg Dept IfD1.1 l=/11 If I Public Works Fee Total Fee Less Am' r" Paid Bller„P nee �.r O Project Address (if known) �72 -- (Cr3 r'Qr s7f •SE. W Illusion _ Attach four (4) copies of plans for proposed work • Draw to scale and note the following as applicable: to • Property Lines • Centerline of street /\ • Outline and dimenuions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements �w DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS ifs O 1. All calls for Inspection shall be made 24 hra in advance - phone 259.881 5. 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 hra before you dig. TOLL FREE NUMBER 1 -800.424.5555. z „rif/ST94L /2�� Co.LX.•eE'rE CULVE.J [-//VUttl�iz C�t'ivEt✓f✓� o 1proved for Co Uuctlo� Date CTION Dal roved as Constructed •erect PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 Phone:259.8815 V♦ O a 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 and maintenance of the improvement or other right•ol•way use hereto applied for and further agrees to remove same upon notice from the City and to replace public grop"y damaged thereby. -SIgnatWofAppffctfni ' 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 BYTHE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER90 DAYS DURATION.