1605 71ST PL SE 2018-01-02 MF Import

Date 2" -O -7 Application For PUBLIC WORKS PERMIT Print or Type Only B7- 58 PobI1C Works ParmH Bldg Dept Public Worke Fee Zj Tmal Fee Leo APPI Fee Paid S O Oh Balance Me • Applicant Mailing Address City Zip Phone Describe Proposed Work A IL I I J W Project Address fit known) Attach four (4) copies of plans for proposed work - Draw to s(rate 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 grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls for Inspection shall be made 24 his. in advance - phone 259.8815. 2. All work shall be performed in accordance with this permit and current City of Everett Design and ConstructI6, Standards and Specifications 3. Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424.5555. ifeWS7X-e T veyc.��<<s To 44-V Approved for Construe on ' Dale FINAL INSPECTION V 5 Date Approved as Constructed I ett PUBLIC WORKS DEPARTMENT Ever tt, WA Street Everett. WA 98201 Phone: 259.8815 ,VOCII= TOP il%9�,r/v✓/lTfi<. ACKNOWLEDGEMENT OF COI DITIONS z O N O a The undersigned owner/applicant hereby agreirs to hold and save harm- less the City of Everett from any and all uhhns icr Lismages, costs, expenses, or causes of action that may wise Because of Installation and maintenance of the Improvement or other right-of-way use hereto applied for and further agrees to remove Beira upon notice from the City and to replace public property damaged thereby. i l nature opplican ! ate 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.