2301 HOYT AVE 2018-01-02 MF Import

Date��s�� Application For PUBLIC WORKS IPERMIT Print or Type Only Owner Describe Propased Work Project Address (il knoH'n) ng Atltlress City i �7/��=-,�P//)iG� /'.Q f� Mailing Address City Zip .'.ip Fubn[W:•MaPrtrm�l� �—��—�� Bia9 DCOt. x �/ � �� i Pu�lic Works Fes $ Tolal Fco Less AppL Fea Po�iE � Baiancc �ue $ � Phone n �� Phone Atlach four �4) copies of plans for proposed work - Draw �o scale and note �he lollowing as applicable: • Property Lines • Centerline ol sireet • Oulline and dimensions of all existing anc� • Indicale Norlh proposed siructures on ihe lot • Show any proposed grading changes • Existing and proposed utilities • Show measuremenls PERMIT CON�ITIONS t. All calls lor inspection shall be made 24 hrs. in advance - phone 259•881 5. 2. All work shall 6e performed in accon�fance with ihis pennit and curreN City of F.verett Design and Construction Standards antl Specilications. 3. Call Location Underground Service 48 hrs. beforz you dig. TOLL FREE NUMBER 1•800•424•5555. /UC'> �/�C/C lc��/',F's i�,� ��7 `_ /Y..�� :/�-��" /. � % - V Approved lor Construction Date FINAL INSPECTION Date Approved as Consirucled evrrett PUBLIC WORKS DEPARTMENT � 3200 Cedar Slreet Everett, WA 98201 Phone:259�&&15 i��c--.o `�,1-�! z Z/�7 , ACKNOWLEGGEMENT OF CONDITIONS � � � Tiie undersigned owner/applicant hereby agrees to hold and save harm� less Ihe City ot Everett from any and all daims tor damages, costs. expenses, or causes of action Ihat may arise because ol installation and maintenance of ihe Improvement or other righbof�way use herelo applied lor and furlher agrees to remove same upon no�ice irom the City and to replace public property damaged thereby. . � ign �ure ol 'ppli an� ;�� Da�e W9 K AUTHORIZED BY FHI9 P/ MIT MUST BE STARTED WIThIIN 180 DAYS O� DATE PEFMIT IS ISSUED AND THEREAFTER IS TO BE DILIGFNTLY PURSUED TO COMPLETION. 7HIS PERMIT 64AY BE CANCELLED BY THE GTY UPON ANY STOPPAGE OF WORK ON i HIS PROJFCT UVER 90 DAYS DURATION.