7020 COLBY AVE 2016-01-01 MF Import

�J � _ Date !�� S. /^� , Tr.r-.�>,.. Application For PUBLIC WORKS PERMIT Print or Type Only y7z�-- _ � !�n PubbcWorktPe�mit• v " _/�/ emc.000y•. i�(i� 1.7�4 �- — "'%/,� 7',1 -' % PuulicWorksioe S � Tota1 fea l¢asAOP�FaePaiO $ �`)� Balon[aDua $ �- �c�� , -�i: Applicant Mai�ing Address City Zip Phone ,� � i-;_/� Descri6e Proposed Work _,��F� �-� = ^ , Pro�ect Address (if known) Attach four (4) coples ol plans for proposed work • Draw ta scale and note the lollowing as applicable: • Proper�y Lines • Outline and dimensions oi a�l ezisling and proposed structures on the lot • Existing and proposed ut�lilies � Cenlerline n( street � Indicate North • Show any proposed grading changes • Show meesurements PERMI7 CUNDITIONS 1. All calls lor inspection shall ba made 24 hra in advance - phone 259•881 5. 2. All work shell be performed in accordance with this permit and current City ot Everett Design and Construction Stendards and SDecilications. 3. Call Localion Underground Sen �:e 48 hrs. belore you dig. TOLL FREE NUMBER 1•800•424•5555. > /� ��/�� 7C%[>�/�%- � Date �- _ .I i . I i. r,. FlNAL INSPEC'i�ON � \ J( Approved as Construcled �) LJ everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phune: 259•8815 Dato ACKNOWLEDGEMEtJT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett Irom any and all claims tor damages, costs, expenses, or causes cf aclion Ihat may arise because ol installation and maintenance of the improvamenl or other right-of•way use hereto epplied for and further agrees tc remove same upon notice from iha Gry and to replaco public property damac�ed thereby. i� .y /�+ �n%!.��CGl��7 � U/%E� a< � Sig�atura oi Applican� 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 MAY BE CANCELLED BY THE CITY UPON ANY STOPPAG[ OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.