2238 74TH ST SE 2018-01-02 MF Import

Date io 'J;)-4v' Application For P(' PUBLIC WORKS PEE TIT Print or Type Only r Owner Pubs¢ OW 0 Permey� Bide Debra�--�— PublK Work$ Fee f{ Total Fee -- Lost $bPl.Fee Paid S 0eltncP Due 5 r Mails no A Idress City Zip Phone .. �� ^ Mailing Address Gdy Zlp Phone Applicant Describe Proposed Work Q C1,yc�In L Ps ,5r C Project Addrp s (if known) ' -- Attach four (4) copies of plans for proposed work • Draw to scale and note Centerline of following as applicable: • Property Lines • Indicate North • Outline and dimensions of all existing and • Show any proposed grading charges proposed structures on the lot • Show measurements • Existing and proposed utilities PERMIT CONDITIONS 1. All calls for Inspection shall be msde 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 Specilicatlons. 3. frail Location Underground Service HC hrs. before you dig TOLL FREE NUMBER 1.800.424.5555. AID Nov 5 90 r, le for nalrucuon FINAL INSPECTION Date Approved as Consrrcted Everett PUBLIC WORKS DEPARTMENT Ever Cedar Street Everett, WA 98201 Phone: 259-8810 10 O M) z O 0 n ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold an 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-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public properdamaged thereby. Signature of Applicant Date WORD 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 T14E CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.