6919 COLBY AVE 2018-01-02 MF Import

Dated2la-r6 C P4cabr-; f 01 PUBLIC WORKS PERMIT Print or Type Only Mailing 3I' f-169 IPubl¢ WOde Perm a �—%{�Vya 7? Dleg. Dept. •ly— Ap`"+ pllcant Mailing Address City Zen Describe Proposed Work _ Aw—ft, OYU_ Pubim Works Fee $ Tolsl Fee Lees Appl Fee PnN S — BebnceDue $ '�"' Phone W r //1 Project Address lit known) Attach four 141 copses of plans for proposed work -Draw to scale and note the following 0s applicable: • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North • Show any proposed grading changes Ch proposed structures on the lot • Existing and proposed utilities • Show measurements DO NOT WRITE BELOW THIS LINE O PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hris in advance - phone 259.8810. be in accordance with this permit and current City of Everett Design and Construction 2. All work shall performed Standards and Specifications. 3, Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800.424.5555. 0 0 am L PUBLIC WORKS DEPARTMENT Ever Cedar Street Everett, WA 98201 Phone: 259-8810 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 damagos, 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. DDe O�i �ItA )"�A ZIP ignalute of pllcant r Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.