620 COLBY AVE 2016-01-01 MF Import

Date��l.r�� (-` Application For PUBLIC WORKS PERMIT Print or Type Only Atldress ,-- PUEIm Wod� Permtl • OIEp. Dept. r � 7� PuOGc Work� Fee Totei Fea s Leis I1pD4 Fee P�iC S BslanceDue i Phone Des�:ribe Proposed Work Projer,t Addrr-55 (il known) Attach four (4) copies uf plans lor propoeed work - Draw to scala anU note the following as applicable: • Property Llnes • Centerline of street • Outiine and dimensione of all eristing and • Indicate North proposetl structutes on the lot • Show any proposed grading changes • ExistinB and proposed utilities • Show measurements PFRMIT CONDITIONS 1. All calls for inspection shall be mode 24 hrs. in advance • phone 259•881 5. ^.. All work shall be performed in accordance with this permit and current City of Everett Design and Constructlon Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. Apvroved lor Construction PE,v.��.r �'F9a��',r� � ,'�9.G �z� ACKNOWLEDGEMENT OF CONDITIONS W N- � � � �"' � � a The undersigned owner/applicant hereby agrees to hold and save harm- less ihe City ot Everett 1rom any and all claims lor damages, costa expenses, or causes of action that may arise because of installation and maintenance of the improvement or other righFohway use herelo applied for and further agrees to remove same upon notice Irom ihe Date City and to replace public property damaged thereby. FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar St�eet Everett, WA 98201 Phone: 259•8815 Siynature ol AUPlicant Dale WORK AUTHORIZEU BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DA7E PEliMIT IS ISSUED AND THEREAFTEIi IS TO BE DIL�GENTLY PURSUED TO COMPLETION. THIS PERMIT NAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK UN TH�S PROJFCT OVER 90 DAYS DURATION.