801 HOYT AVE 2016-01-01 MF Import

Date �` 3�Y Application For @U�LIC VVORKS PERMiY Print cr Type Only Owner Describe Proposed Work Prolect Address (if known) UI U Mailing Address %u�3� �a Mailing Address �- �n� -- R�� r C„ 2 PuGLa1'lorksPn �+ _ B1�9. Dopt + � �'( �� PUEIic IYorka Fae y, Total Fee Less AppL Fee Pald S �aiacco oua 5 Lip rnone Attach four (4! copie5 of plans tor proposed wo�k - Dmw [o scale and note ihe followinc� as applicable: 0 Froperly Lines • Centerline of street o Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed gradin� changes O Existing and proposed utililies • Show measurements PERMIT CONDITIONS 7. All calls for inspection shall Ee made 24 hrs. in advance - phon�: 259•881 5. 2. All work shall be pertormed in accordance with this permit and current City of Everett Design and Construr.tion Standards and Specifications. 3. Call Lecation Underground Service 48 hrs before you dic�. TOLL FREE NUMBER 1-800-424-5555. �f; ��o �� Y^ (� �� � /q/� ��i� �i�� 'i"' � �� . L,' - ApP�a�ed for Conslruction Date FlfJAL INSPECTION Dare Approved as Constructed everett PUBLIC WOPKS DEPARTMENT � 3200 Cedar Sireet Everelt, WA 98201 Phone: 259-BB15 � '� � •: � � ACKNOV✓LEDGEtdENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm- � less �he City of Everett trom any and all claims lor damages, costs, expertses, or causes of action that may arise because ol inslallation and maintenance of ihe improvement or other righbohway use hereto applied for antl furth^r agrees lo remove same upon notice Irom ihe City and to replace public property damaged ihereby. SignaWre of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST 6E STARTED WITHIN 180 LIAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE fiILIGENTLY PURSUE� TO COMPLETION. THIS PERMIT MAY BE CP.�VCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. f r"