1421 74TH ST SE 2018-01-02 MF Import

Date3 Application For PUBLIC WORKS PERMIT Print or Type Only ,,,c ONner 7th s", Public Wode Permit • / D �a Bldo Door. a Ao/ Public till Fee e Total Fee Lau Appt Fee Paid Balance Due �/t �yAsln3 35 s=5Y3/ ' ZID Phone r01 e City Zip Phone Applicant Melling Address Describe Proposed Work 'Z - Project Address (If known) Attach four (4) copies of plans for proposed work - Draw to scale and note llotaing as lerllne of street able: • Property Linea • Indicate North • Outline and ceder dimensions all existing and • Show any proposed grading changes • Existing anndd proposed thutilities e lot proposed • Show measurements r PERMIT CONDITIONS 1. All cells lot Inspection shell be made 24 hrs In advance - phone 259.8815. 2. All work shall he performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications 3. Call t ^cation Underground Service 48 hrs before you dig. TOLL FREE NUMBER 1.800.424.5555. P,Lblr14 wt"Its Np r VA Lie A N us1 ^ S ext�"� �� Air Je"'" I Approved for Construction Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC'NORKSDEPARTMENT Ever tt. WA Street Everett, WA 98201 Phone: 259.8815 ACKNOWLEDGEMENT OF CONDITIONS W F- 00 In O oal, 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 ar'-e because of installation and maintenance of the Improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant Dete WORK AUTHORIZED OF E DATE PERMIT ISISSUED AND THEREAFTER ISRMIT MUST BE STARTED H IN 180DAYS 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.