2812 COLBY AVE 2016-01-01 MF Import

Date 7��'�� l� �` Pu76cWoikePermit+ _ � � em0.oeo��+ AppliCa�ion For PUBLIC WORKS PERMIT CueTo�FeaFee 5 ��ss noo�.Fce Pa�e S eai,ncc oue $ Print or Type Only ��'1/�/-�� '��1 K�� /77�l�f1��71i /�ilJY� �I /��'r�l�T- `I�'�C/ Ow er Mailing Address City Zip Phone AFplicant Mailing Address City Zip Phone Describe Proposea Nlork T�� `�� - � - `� - W �� y �,,, H Proiect Address(if known) ._�L1/ � Attech four�4)copies ot plens for proposed work- Draw to sca e and note the following as applicable: � • Proporty Lines . • Centerline ol street • Outline and dimensions of all existing and • Indicate North proposed struclures on the lot • Show any proposed grading chenges • Ezisting and proposed ulilities • Show measurements M W �` DO NOT WRITE BEIJW THIS LINE O PERMIT CONDITIONS 1. All calls tor inspectlon sha�l be made 24 hrs. in advance•phone 259•881 5. � L ,All work shail 6e performed in accordance with this permit and current Cfty ol Everett Design and ConsVuction Standards and Speci�ications � 3. Cal�Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800•424•5555. P��c �b� �.��,— �tJdr,�qa�,e�'o `�� O � � � a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applica�t hereby agrees to hold and save harm- less the Ciry of Everett irom any and all claims for damages, cos;s, ezpenses, or causes of action that may arise because ol instal�ation and maintenance of the improvemenl or other right-ohway use hereto applied lor and further agrees to remove same upon nolice Irom the Approved for Construction Date City and lo replace public property damaged Ihereby. FINAL INSPECT�ON Date Date Approved as Constructed Signature of Applicant PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN everett 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER �S TO � 3200 Ceder Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY 8E Everett,WA 98201 CANCELLED 8Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS Phonc: 259-8815 pROJECT OVER 90 DAYS DURATION.