2828 COLBY AVE CASCADE BANK 2018-01-02 MF Import

Date Ili I0 R Application For PUBLIC WORKS PERMIT Print or Type Only Mailing Address Describe Proposed Work 1a AhJ I Z: 1 (-I' , Project Address (if known) Lilly Public works Permit a Slap. Dept. a Public Works Fee S Total Fee Less Appl Fee Paid S Balance Due S Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: • Pro 'y Lines • Centerline of street • Outi,, . and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements Phone PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hra in advance - phone 259.881 5. [. All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.80 •424-5555. /CU CellU ►F��°C� Approved for Construction FINAL INSPECTION Date Approved as Constructed i PUBLIC WORKS DEPARTMENT 3200 Cedar Streit Everett, WA 98201 Phone: 259.8815 ACKNOWLEDGEMENT OF CONDITIONS W co O M) Z O H O a 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 for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST RE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEP 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.