1110 84TH ST SE 2018-01-02 MF Import

v' 1U5- % Public Works P[rm�l• yr•�� 0 Date t-21 eiav Deer• 39320 Application For PUBLIC WORKS P9 TNG �Z� Print or Type Only Public Works Fee Tnlal Fee Less ePPi Fee Paids �^ asiene, Due B Tim Sandberg PO Box 333 Lakewood We 98259 659-9586 Z'r Phone Owner Mailing Addresr. Clly Owner Phone Applicant Mailing Address City Zip Describe Proposed Work new house 1110 8'�h r'GGIi '%� Lot 1 Project Address (if known) able: eet Attach four (4) copies of plans for proposed work - Draw to scale and note Ceniterline of ste wing as reet • Property Lines 0 Indicate North • Outline and dimensions of all existing and Show any proposed grading changes proposed structures on the lot 0 Show measurements • Existing and proposed utilities M W DO NOT WRITE BELOW THIS LINE 0 PERMIT CONDITIONS 1. All calls for inspection shall be made 24 lira. In advance • phone 259.8810. with this permit and current City of Everett Design and Construction 2. All work shall be performed in accordance Standards and Specifications. Service 48 hire. before you dig. TOLL FREE NUMBER 1.800.424.55 3. Call Location Underground 0 0 a Approved as Constructed PUBLIC WORKS DEPARTMENT OW 3200 Ceder Street Everett. WA 98201 Wr Phone: 259-8810 ACKNOWLEDGEMENT OF CONDITIONS The rees d and save harm- lessulheeCity of owner/applicant a any and allllgo claimsfood 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 foyremove same damaged herupon notice from the City and to rep public ate nature of Ap ant RK AUTH IZED . HIS PERMIT MUST BE STARTED WITHIN 180 DAYS F DATE ERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCE LE BY THE CITY UP CT OS DN ANY STOPPAGE OF WORK ON THIS PROJEVIER 90 DAYUR