608 65TH PL SE 2018-01-02 MF Import

V -G-20- S AA Date-3rt T-91 Application For PUBLIC WORKS Print or Type Only Owner TO POSTING_ PERMIT Mailing Aalress, Owner _ Applicant Mating Address Describe Proposed Work new conatruction;SFR Project Address (if known) pp pO �p'ir i V7 M 1n rl �iFO P Jl ( Pf, I '(; :Evaret city - r lc:�-17H PLAGG 5lff Lo hb„ a WOrMs Penns + Z /- sae DOW a 36000 Pubbe works FeA s TolAl iaa Lass Aml Fee POC i Balance 0vA s Attach lour 14) copies of plans for proposed work - Drava to scale and 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 gradi tg changes • Existing and proposed utilities 0 Show measurements Phone PERMIT CONDITIONS 1. All calls for Inspection shall be made 24 hra. in advance - phone 259.8810. 2. All work shall be performed in accordance with this permit and current City of Everett Desl,ln and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. Date S-/z -Tz— Approved as Constructed PUBLIC WORKS DEPARTMENT qvff 3200 Cedar Street Everett, WA 98201 Phone: 259.8810 W h Im 0 z 0 0 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, cost& expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replaces public ppropp�erty damaged thereby. ^ p -, Signature of Applicant Data WORK AUTHORIZED BY HIS PERMIT MUST BE STARTED WI'HIN 180 DAIS 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.