1505 81ST PL SE 2018-01-02 MF Import

Cz ov�ya c~it I'a K W H �Nq V. H z 4 b OH fLoaZH 9H t H H gy H �qqd� p1 r H GO HOT/n Q1 Date �r Application Fo PUBLIC WORKS PERMIT Print or Type Only Nbbe WOlxa Permtl a O�'3i 8" Door Nbl¢WMFc fee ---_. -.- Talel roe -- Lau APPI Fee PAW Btlence Due Applicant Meiling Address City Zip Phone Describe Proposed Work ---- Project Address lit known) Attach four (4) copies of plans for proposed work • Draw to stele and note the following as appkcabW • Property Lines • Outline and dimensions or all existing and • Centerline of street • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calla for Inspection shell 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. Cell Location Underground Service 48 his. before you dig. TOLL FREE NUMBER 1.800.424.5555. as Constructed 0evrrrll PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 Phone, 269.8810 ACKNOWLEDGEMENT OF CONDITIONS W a'.�wyl im O n Z O O a 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-of-way use hereto applied for and further agrees to remove same upon notice born the City and to replace public properly d w a ed thereby. ' t'/ cif' Signature App (cant Date WORK THORIZED BY T IS PERMIT MUST BE STARTED WITHIN too 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.