1324 74TH ST SE 2018-01-02 MF Import

( i ' Dbte7-_ ppiication For PUBLIC WORKS PERMIT Print or Type Only Describe Proposed Work Public Work, Permit a Bldg Debt e Public Work, Fee • Total Fee Lee, Apo[ Fee Pad Balance Due • `2 0. ni] Project Address fit known) %VT1 91— 56&y. _l ?2o} _ LU Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: ttra • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North V proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements DO NOT WRITE BELOW THIS LINE O 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 Construction Standards and Specification& 3, Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1 •800.424.55515. �. cl %1 b'0• �i-�< ,p� St /Jf-=o/ IL.Aq war�� 1 � Fm / l/wJ c I O a Approved for Cdnstruction Dete FI L INSPECTION � Dale Approved as Constructed PUBLIC WORKS DEPARTMENT 3200 Ceder Street i Everett, WA 98201 Phone: 259-8815 ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett Irom 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-of-way use hereto appl ed for and further agrees to remove same upon notice from the City d to replace public pr party damaged thereby. Signature of Applicant Date 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. H S N Z O Fn m