2410 74TH ST SE 2018-01-02 MF Import

Date /D Application For PUBLIC WORKS PERMIT Print or Type Only Describe Proposed Work -1y1r`ln1' PubliK wore Perm" . Bldg Dept e Public Works Fee Total Fee S Less eppt Fee PAW S Vv Project Address (if known) 02 9�e4O 4 Sf• = E_ Illinois Attach four (4) copies of plans for proposed work • Draw to scale and note the following as applicable: • Property Lines • Centerline of street / w • 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 PERMIT CONDITIONS O 1. All calls for inspection shall be made 24 hra In advance - phone 259.881 5. 2. All work shall be performed In accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hire. before you dig. TOLL FREE NUMBER 1.800.424.5555. z O latyei( Approved for Const Date FINAL -INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT 11 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 FM () 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, 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 a eplace public rty damaged thereby. Slgna re of of Applicant Date W AUTHORIZED B PERMIT MUST BE STARTED WITHIN 1 0 DAYS OF DATE ER T 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.