818 89TH ST SE 2018-01-02 MF Import

X Date x Application For PUBLIC WORKS PERMIT Print or Type Only A I Owner PubllC Works Permll • C9 ✓ �^�- Bldg Dept. a ^Z SD Publk WPrka Fee Total Fee --�- Leo APPL Fee Paid S Balance Due Applicant Melling Address City Zip Phone Describe Proposed Work W - v - — Project Address III known) D T>'� S� nIiiiiiiiiin Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: tllllllll� • Property Lines • Centerfine of street • Outline and dimensions of all existing and • Indicate North v� proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Shrw measurements DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS O 1. All calls for inspection shall be made 24 hrs. in advance - phone 259.8815, Wall 2. All work shall be performed in accordance with this permit and current City Of Everett Design and CGnstruetlon Standards and Specifications. 3. Call Location Urderground Service 48 fire, before you dig. TOLL FREE NUMBER 1.800.424.5555. /7 i Approved for Cdfistruclion ZDate t FINAL INSPE TION— Approved as Constructed everett PUBLIC WORKS DEPARTMENT 3200 Ceder Street Everett. WA. 98201 Phone: 259-8815 O a ACKNOWLEDGEMENT OF CONDITIONS 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-il use hereto applied for and further agrees to remove same upon notice from the City and to replace nubile property damaged thereby. Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STAR-ED i iN 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.