2421 81ST PL SE 2018-01-02 MF Import

�.. .. .. t. �:,'—;rr'...•"-....,,t:r.�..,.,_,�:.yrpG:iyt'i tT'!'S''-','•r^i" _'��:�' .,,_ �._.-.._ Date�Rq Applicnh, , i ,v PUBLIC WORKS PERMIT Print or Type Only rill Pubes Wmlla Patel, 61do Dept. r P.M. WaW Fee 1< Tote, Fee ------ toss Apol Fee Pad Balance Due Sang! Applicant Mailing Address City Zip Phone Describe Proposed Work Project Address lit known) . 1 21,r o,T=lf=f( - v - Attach four (4) copies of plans for proposed work • Draw to scale and note the following as applicable: • Property Lines • Centerline of street 0 Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes 0 Existing and proposed utilities • Show measurements DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS 1. All calls for Inspection shall be me& 24 his. 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 hra. before you dig. TOLL FREE NUMBER 1.800-424.5555. �"- - p%v Approved lot Conatr lion Data FINAL INSPECTION Date Approved as Conslrucled E PUBLIC WORKS DEPARTMENT Ceder Street Everett, WA 98201 Phone: 259-8810 ACKNOWLEDGEMENT OF CONDITIONS W 7 • J z O FM r (/ 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 from the City to replace public property damage 1 thereby. M rt Sig alur o AppIIcadt Date WORK AUTHORIZED BY THIS PERMIT MUST BE ST RTED 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 Wr RK ON THIS PROJECT OVER 90 DAYS DURATION.