130 74TH ST SE 2018-01-02 MF Import

Date 13L4'r Application For PUBLIC WORKS PERMIT Print or Type Only ......l ..y Describe Proposer, Nork Protect Address tit known) _ w� '—�� &' Zip Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable. Property Lines • Outline and dimensions of all existing and Proposed structures on the lot • Existing and proposed utilities Rrb4c Wbga Perm�r • (� �/� eld0 peer Public Wonr Fe. TOIe1 Fee Leu cool Fee Pa-d-- salance0ve j_pF�OO • Centerline of street • Indical r North • Show uny proposed grading charges • Show measurements 3� Phone PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance - phone 259.8810. 2. All work shall be performed In accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Cell location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555 Approved for Conslru ion Dale FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA g8201B201 Phone: 259.8810 ACKNOWLEDGEMENT OF CONDITIONS Uj CIO O n z O O a The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, costs. expenses. or causes of action that may arise because of installation and maintenance of the improvement or other right-ol-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public properly damaged thereby. Signature of APPllcant OAIe WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND TFEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THI i PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.