828 90TH PL SE 2018-01-02 MF Import

Datelz��ry�� Application For PUBLIC WORKS PERMIT Print or Type Only 1ti P•R-A• 6ONIT �'ACTc_R Owns- ng ACCress Appllcanl City Zip F ,bft Wnrka Permx a — 0,02 B'dg Depta i�/ / 5�e Pebkp Worka Fe. 7-,1 Fe. lose Appt Fee Paid S salaMa Co. 6 2a�00 Describe Proposed Work �OF -!5, f H (oLZ FAVA 1t rFF f C5 9031- OQ1 SE Project Address (if 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 dimbrllons of all existirg and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS A GS-1-7300 Phone Phone 1. All calls for inspection shell be made 24 fire. 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 Specification& 3. Cell Location Underground Service 48 hr& before you dig. TOLL FREE NUMBER 1.800.424.5555. D PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 Phone: 259.8815 ACKNOWLEDGEMENT OF CONDITIONS 1 �1 D z O Cl) O a The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any a•id all claims for damages, coat& 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 agr es to remove same upon notice from the City and to replace public pr perty damaged thereby. Slbneture of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER 13 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.