5031 HARBOR LN 2016-01-01 MF Import

Date ' t3' �' -�-a Applicetion Fot PUBLIC WORKS PERMIT Print or Type Only Mailing Address Mailing G�� Describe Proposed Work 51�.1,�+LLr �oc�✓14LY 'L��S�'D�T1TIhL Pro�ect Address (if known) Attech four (4) copies of plans for proposed work • Draw to scaie and note the following as applicable: • Property Lines • Outline and dimensions of all existing and proposed structures on the lot � Existing and proposad utilities PERMIT CONDITIONS Pu011eWorkePeQrm'lt�• ��69 BIOp. Depl t -0y[' r �' PuDlie Worke Fee TotelFae 8 Lean FppL Fen Pe1C s n n BalanceDue S <Q��/ � Centerline of street • Indicate North • Show any p�oposed grading changes � Show measurements 3S'3-O$l¢ Phone Phone 1. All calls for inspection shall be made 24 hrs in advance - phone 259•881 5. 2. All work shall be performed in eccordance with this permit and current City of Everett Design and Construction Standerds and Specifications 3. Cell Locatlon Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800•424•5555. �MMIVYCYIVIUVI1pl1Uli11V1V A � 41A1C ��I�� . INAL INSPECTlON Date �Approved as Constructed � everett PUBLIC WORKS DEPARTMENT � 3200 Ceder Sireet Everett, WA 98201 Phone: 259•8815 ACKNOWLEDGEMENT OF CONDITIONS W H � � � O �' a The undersigned owr�eryapplica�.n hereby agrees to hold and save harm- less the Cily of Everetl Irom any and all claims for dameges, costs, expenses, or causes ol action that may arise because of installation and maintenance of the improvement or other right•of-way use hereto applied lor and fuiiher agraes '� remove same upon notice from the City and to replace public property damaged thereby. ,tiv G�,.%ZG,d /D / eQS g ature ol Applicant ate RK AUTHORIZED BY THI PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSI'ED AND THtREAFTER IS TO BE DILIGENTLY PURSUED TO COI�APLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT UVFR 90 DAYS DURATION.