1610 63RD ST SE 2018-01-02 MF Import

Date._J11_,I Application For PUBLIC WORKS PERMIT Print or Type Only Public Dept * PerQQmM:�aJ]� eldp DeoL • ,mil Public Works Fee Total Fee S Less APPr Fee Par s Balance Due S Z INVANITAir Applicant AA � 11 Mailing Address City Zip Phone Describe Proposed Work l��rt 1___��_^ -- - w Project Address lit known) Attach four (4) copies of plans for proposed work • Draw to scale and note the following as applicable: • Property Lines • 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 Im DO NOT WRITE P.ELOW THIS LINE WY PERMIT CONDITIONS V 1. All calls for Inspection shall be made 24 hra in advance • phone 259.881 5. 2. All work shall 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 0 0 1 am ACKNOWLEDGEMENT OF CONDITIONS ale 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, causes of action that may other because of Installation and maintenance of the Improvement or other right•ol•way use hereto applied for d further agrees to remove same upon notice from the pproved fix Constructer Dpublic damaged thereby. INAL INSPECTION ; !-Yale '— pproved as Constructed S u II ant Date PUBLIC WORKS DEPARTMENT WORK AU RfZED BY THIS PERMIT MUST BE STARTED WITHIN 3200 Cedar Street 180 DAY F DATE PERMIT IS ISSUED AND THEREAFTER IS TO 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE Everett, WA Phone: 25A.86 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.