815 84TH ST SE 2018-01-02 MF Import

Dateit!Liff—C--1 Application For PUBLIC WORKS PERMIT Print or Type Only IL K Describe Proposed Work _M11 � Project Address fit known) :A ft3 PUEbe Worke Per�y.� _ Bldg Door • _: Puck Works Fee Total "a s Use ApPr Fee Paid s Balance Due Zip Phone Zip Attach four (4) copies of plans for proposed work - 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 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 hrs. before you dig. TOLL FREE NUMBER 1.800-424.5555. S/ Y/ V- Approved as Constructed PUBLIC WORKS DEPARTMENT 3200 Ceder Street Everett, WA 98201 everett Phone: 259.8810 ACKNOWLEDGEMENT OF CONDITIONS W U) M O n z O 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 to or agrees to remove same upon notice from the City en o rgpfdc§.bublic property damaged thereW U g0P4CAUTHORIZEIYBY THIS PERMIT MUST BE STARTED WITHIN ISD DAYS OF DATE PERMIT IS ISSUED AND T14EAEAFTER 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. '