1525 75TH ST SW BASE FILE 2018-01-02 MF Import

Date Application For PUBLIC WORKS Print or Type Only a Describe Proposed Work PERMIT Mailing Address Zip Peblk V. nW Perna / _7 axto DeV. Pub", Wora-rat ` S9 total Fee Let&-pol Fee Pace s -ram Balance Due 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 • Existing and proposed utilities • Show measurements Phone PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs In advance - phone 259.8815. 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 hra. before you dig. TOLL FREE NUMBER 1.800.424.5555. Ejl7c,Pl� cn�C f/ S/T� G�frC�i�/c� �it-_� Approved as ConstrucledJ everett PUBLIC WORKS DEPARTMENT Ever Cedar Street Everett, WA 982018201 Phone: 259.8815 , ACKNOWLEDGEMENT OF CONDITIONS W H Im 0 Iw z 0 F, e The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and ail claims for damages costs. expenses or causes of action that may arise because of installation and maintenance of the Improvement or uther right-of-way use hereto applied for and further agrees to remove same upon notice Irom the City and tojeplacepubliepTperty cfji�aged thereby. tuign5jjvK6of Applicant WORK 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.