2221 73RD ST SE 2018-01-02 MF Import

gate L-IN-L� Application For TO POSTING ! a pp Dept . _L %13 t1 = = PUBLIC WORKS PERMIT Tpl.�ree Le°. Appi Fee Pad 5 B.bnce Dun Print Or Type Only Address Crty Phone 'U-19_L_ Applicant Malting Address city Zip Phone Derr Proposed Work Uj ProleclAddress (if knoon) 222/ — 7.3to S6 Attach four t4) 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 proposed structures on the lot • Show any proposed grading changes • Exls-mg and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calla for Inspection shall be made 24 his. In advance • phone 259.8810. C"n f 2. All work shall be performed in accordance with this permit and current City of Everett Design . Fid Construction Standards and Specifications. 3. Call Location Underground Service 48 his before you dig TOLL FREE NUMBER 1.800.424.5555. IA Approved / Construc I rl a:9 f '�=J!e?/�� FIN INSPECTION Date Approved as Constructed W PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everele tt WA 95201 Phone: 259-8810 ACKNOWLEDGEMENT OF CONDITIONS The undersigned ownedapplicanl hereby agrees to hold and save harm- less the City of Everett from any and all claims lot damages costs. expanses. or causes of action that may arise because of Installation and maintenance of the improvement or other fight -of -way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. '§�fn'ature of AVplicani Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO RE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.