2610 81ST PL SE 2018-01-02 MF Import

Datee2 Application For PUBLIC WORKS PERMIT Prir-1 or Type Only Public Works Permit e 81,19 Dept e Puerc wot4 Fee — Total Fee Less Apot Fee Para Silence Due i ao .0 O 11l> />l/li2 y'fo%Q�.,',5hg�zry 3j2rLsir. ..Yu �;ursert �� 9D y 5� � , Owner Meiling Address City Zip Phone ApplIcallif Mailing Address City Zip Phone Describe Proposed Work _4�.oa1S/r.•>< dV/y Pv,tJat/ Project Address (if known) Attach four (4) coples of plans for proposed work - Draw to scale and note the following as applicable: • Pioperty 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 023 tt� PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs, in advance • phone 259.8815. 2. All work shell be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Locatlor Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. i3k� �l0�-1 Plate dn�et a �oeln` Pia« 9ePpos.le 1 eft 0 (o � �Glcl t t+ ta• 4 1 %J4' 1 w C",r10 C.+—e = -(- k b� �PP A itouS� 1�1 NO 1 i r✓ ^.. 0I /nPw a�lf ..t 1uw n, c i,Y 01-0 Cf rti to re�4-_Q re-f `der t^'•M Ct 16 n—&2 g,tANe.r at 5:0(ew Pu Saa,G.a:.. 3.3. 7 ..� P. w s �-k..�•An. a3(� 146 ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm - loss the City of Everett from any and all clainis for damages. costs, �T�7 expenses. or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto cam" applied for and further agrees to remove same upon notice from the A-provllor Co Iructlon Date City and to re ce public pr party damaged thereby. FINAL INSPECTION Date a� "�-�• -y- Approved as Constructed Signature of lice / Dete rvrmtt PUBLIC WORKS DEPARTMENT WORK AU flIZED BY THIS PEP'd1T MUST 3 STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO 3200 Ceder Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE Everett. WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS Phone: 259-8815 PROJECT OVER 90 DAYS DURATION.