6616 HIGHLAND DR 2016-01-01 MF Import

oa,e�q � Application For PUBLIC WORKS PERMIT Print or Type Only �C/'rNO�ilf//�/`.�CG/`h3 �� Owner Mailing A ,s ,SD L Applicanf Mailing Address Describe Proposed Work N PG(/� C� Project Adtlress lif known) � City CitY Lp Attach �our (4) copies of plans lor proposed work - Draw to scale and nute the following as applicable: � • P�operty Lines • Outline and dimensions of all existing and propOSUd 5tructUreS on the lot • Ezisting and proposed utilities PupL[ Wo�45 Per t • a�„9 ��o, . �9�i6�—= Puehc Wwb Fea Tolnl Fce S La55 Rp01. FBe Pdid s Bslance Oun s • Centerline of street • Indicate North • Show any proposed grading changes • Show measurements PERMIT CONGITIONS 1. All cello for inapection shell be made 24 hra. in advance • phone 259�8810. 2. All work shall be peAormed in eccordence with this permit iand current City of Everett Desipn end Conslruction Stantlarde and Specifications. 3. Cell Location Underground Service 48 hrs, bafore you dlg.'rOLL FREE NUMBER 1•800-424•5555. f��c,.G�C u/ov�- f�i�.�� '•�- ��gti-r� Approved tor Consiruction Date FINAL INSPECTION Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cader Street Everett, Y!A 98201 Phona: 259•BB10 Date 9f �!� � �/-B9 ACKNOWLEDGEMENT OF CONDITIONS W F- � The undersigned owner/applicent hereby agrees to hold and save harm- less the Ciry of Everett Irom any and all claims for damages, cost4 expenses, or causes of action that mey arise because of installation and maintenance of the improvement or other right•of-way use hereto applied for and further agrees to remo�e same upon notice trom the City and to replace public property damaged thereby. Signature ol Applicant 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 STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAVS DURATION.