2518 74TH ST SE 2018-01-02 MF Import

Date 2-23=93 L - Apolication For PUBLIC WORKS PERMIT Print or Type Only TO POSTING K- — -94 Public Works Permit OC Bldg Dept • 39651 Public Works Fee Total Fee $ Less Agbl Fee Paid S All Due $ Lyle Blank PO Sox 2:66 Everett WA 98203 355-4725 Owner Mailing Address City Zip Phone Owner Applicant Mailing Address City Zip Phone Describe Proposed Work new house Project Address (if known) 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 dimensions of all existing and • Indicate North Proposed structures on the lot • Show any proposed grading changes to Existing and proposed utilities r.� • Show measurements PERMIT CONDITIONS 1. All calls for Inspection shall be made 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 Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. A. Pave, d(Jojty✓ati , In -01c, �t9►,t 51 puck- 1'11 So►k,(ka-CArk ;h elIhb►io.�-► &r W1641 4W CokJJM1 QeAs;&1 6ioli Fill. as Constructed 01& PUBLIC WORKS DEPARTMENT 3200 Ceder Street FVcr011, WA 662u1 Phone: 259-8810 ACKNOWLEDGEMENT OF CONDITIONS W in O z 0 0 CL 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 arose 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. S Olatute of Apphcanl Date ORK 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.