1820 72ND PL SE 2018-01-02 MF Import

Datefl� % Applicalion For PUBLIC WORKS PERMIT Print or Type Only City N Publ¢ WOlke POMd • 98 Bldg. Depr ay-+-I--f-- Public Wolkr Fee S Total Fee Let, Appr roe Paid !i Be'ence Due >j 2000 Phone ppllcant Meiling Address City Zip Phone Describe Proposed Work 9 Cl r Project Address (if known) Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: * Property Lines • Centerline of street o Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes M Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls for Inspection shall be made 24 hr& in advance - phone 259.881 5. 2. All work shall be performed In accordance with this permit and current City of Everett Uesign and Construction Standards and Specifications. 3. Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1 -800.424.5555. Approved for Construlftion I 15ate FINAL INSPECTION Date Approved as Constructed i ett PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett. WA 98201 Phone: 259.8816 ACKNOWLEDGEMENT OF CONDITIONS N Im 0 r z O FM N O a The undersigned ownertapplicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, coals, expenses. or causes of action that may arise because of installation end maintenance of the Improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the Ci-y e d to replace public property damaged thereby. L Signature Appllca 1SDete WORK A ORIZED 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.