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� . AjOD tT LO I,_ ._• <br />PC--e.wu. r5 <br />t F F I L-- t s <br />,JC57F 710 <br />5n,J-174- <br />9iiO6 <br />Approved for onstruction ate <br />FINAL INSPECTION Date <br />Approved as Constructed <br />W <br />PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />Everett, WA 98201 <br />Phi is: 259.8815 <br />Date6 <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Publlb Worke Perm,l a <br />Bldg DOW e <br />Public Works Fee <br />Tole, Fee i - <br />Lue April Fee PIN L� <br />Balar¢e Due S <br />no <br />Applicant M�e"l'liin"g �Address City Zip Phone <br />Describe Proposed Work _�t{.ec4�--r{xyl--F�'�—`t��'^ <br />-- ✓ lh/ti k 145 >Y/n aN NA if ll/f%J <br />Project Address lit known) � 3/T — <br />Attach lour (4) copies of plans for proposed work • Draw to scale and note the following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 his. in advance • phone 259.8815. <br />2. All vork shall be performed In accordance with this permit and current City of Everett Design and Construction <br />Standards and Specllicatlons. <br />I. Cell Location Underground Service 48 hrs, before you dig. 1 OLL FREE NUMBER 1.800.424.5555. <br />6'eCU4f+1" f 1_1. <br />ACKNOWLEDGEMENT OF CONDITIONS <br />z <br />O <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, costs. <br />expenses, or causes of action that may afise because of installation <br />and maintenance of the Improvement or other righl•of•way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />v <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />