2625 HOYT AVE 2016-01-01 MF Import

� � TYPE OR PRINT ONLY Describe Proposed Work Application For PUBLIC ViIORKS PERMIT PUBLIC WORKS DEPARTMENT 3200 Cedar Street Evere!t, Wq g8201 259-8810 City n _ „ PROJECT ADGRESS (if known) _ � i Date ___�=�� Public Works Permit q_�1p12 S� _ Bcilding permit q Public WoJ�'� �Fee $ � � /7�rFi�f �u��y+vi� . -. . - '�?ri': _,. . ic_ � .�— y-=�-'�SYL � Z�P Phor — �' � i a. � Attach four fqj copies of plans for pmposed work - Draw to scale and note Ihe followinq if applicable: QTYFF � ��. �0 •Property Lines •Outline and dimensions of all existing and pmposed structures on ihe Im •Existing and proposed utilities-' ''HEC!; 4?O.OD •Centedine of street •Indicate North •Show any proposed grading changes •Show measuremenls PERMITCONDITIONS: — �"" '"""""'-vvv �nio uNt 1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. 2. All work shall be F�rtormed in accordance wilh this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 4F hrs. be�ore you dig. TOLL FREE NUMBER 1-�90-424-5555. A�. �►v{�-I� d,�,:n -}o ak:s-4-�Kc� c2�+r�t b�s�►, �Ks-t�+u pr�v�f Gx�>k�y rah'+ tx. -��nu�)- z 4 � � � � ACKNOWLEDGEMENT OF CONDITIO�JS The undersigncd owner/applicant hereby agrees to holtl znd save harmless ihe City o( Everett from any and a!I claims for damages, cests, expenses, or cau,es ol action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto applled for and further agrezs to remove same uoon notice fmm the City and to reptace public property tlamaged thereby. I •�•r��•=.. �:, wnsimciea / % -� , � � Signatur�Applia rt � �a�e WORK AUTHOflIZED BY THIS PERMIT MUST BE uTARTED WITFIIN 780 DAYS OF OATE PERMIT IS ISSUED AND THEREl�FTER IS TO BE �IL�(iENTLY PURSUE� TO COMPLE�ION. iHIS PERMIT MAY BE CANCELLED BY THE CIN UFON ANY STOPPAGE OF WORK ON THIS PROJFCT OVER 90 DAYS DURATION.