2208 74TH ST SE 2018-01-02 MF Import

Date.-3I1/.aP/SG Application For PUBLIC WORKS PERMIT Print or Type Only PpbIK Work, Pumlt e S(,— /7/,7- elda Dept a _XfP7 / tQ 2 a Pebbd wore. Fee Total Fee S Lau Appl Fee Paid S aCwn Dua $ _ �QO "C s1 0 -s_k vvnm muumy noaress Clty Zip Phone Applicant Mailing Address City Zip Phone Describe Proposed Work Project Address (II known) _siry. 0 •i — / 7 Attach four (4) copies of plans for proposed work • Draw to scale and note the following as applicable: • Property Lines • Centerline of street • Outline and dimen3lons of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed ulililies • Show measurements PERMIT CONDITIONS 1. All calls for inspection shell be made 24 hire. In advance • phone 259.881 5. 2. All work shall be performed In accordance with this pormit and current City of Everett Design and Construction Standards and Specifications. 3. Cell Location Underground Service 48 hra. before you dig. TOLL FREE NUMBER 1 •800.424.5555, vwm z Q O a. ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm• less the City of Everett from any and all claims for damages, costs. c expenses, or causes of action that may arise 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 approved forCiefistrut n Data City and to replace public property damaged thereby. Zp 1 INAL INSPECTION pproved as Constructed Signature of Applicant IDate .Verna PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO Everett, WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE Phone: 259.8916 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.