2505 81ST PL SE 2018-01-02 MF Import

Date'0L3 Application For PUBLIC WORKS Print or Type Only 422 11.3""14b Melling ERTROWRn PERMIT 071983 CITY OF EVERETT Pct:l.: Wcrks Dent. City Public Wa,he Penml a Bide. Dept Or 3 Public Worts Fee • 0O 1obl Pee Leas ePar Fee Paid Balance Due ICI"/a 9 84' Ise City Zip Phone Describe Proposed Work ��• —� 1 n wi, e, Project Address (if known) Attach four 14) copies of plans la proposed Ark - 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 PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hre. In advance - phone 259.881 5. 2. All work shell be performed In accordance with this permit and current City of Everett Design and Construction Standards and Specifications, 3. Call Lncatlon Underground Service 48 fire. before you dig. TOLL FREE NUMBER 1 .800.424.5555. -/o -,F3 uete FINAL INSPECTION Date Approved as Constructed D PUBLIC WORKS DEPARTMENT 3200 Ceder Street Everett, WA 98201 Phone: 259-8815 ACKNOWLEDGEMENT OF CONDITIONS W H sttttt� 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 some upon notice from the City and to replace public property damaged thereby. w _ SI nature of Applicant Date WORK AUTHORIZED BY THIS PERM UST 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.