5031 HARBOR LN 2016-01-01 MF Import

�flt@�� C �P • • PUE1ic Work� Permll • Anplication For I aieu. o.p�. •_ PUBLIC WORKS PERrJIIT Print or Type Only Describe Proposed Work 1� � Project Address pf known) Me6ing Address .� �-; Mailing Address r!`�e — cny c�ry Attach four (4) copies of plans for proposed work • Draw to scale and note the lollowing es applicabia: • Property Lines • Outline and dimensions of aIl existing and proposed structures on tha lot � Ezisting and proposed utilities Publ c WZA� Fee 1MnIFee S Lese ApO� Foe P�IE S BelencaDue i Phone 33� - � //� Phone • Centerline o'sireet • Indicate Norih � Show any proposed grading changes • Show measurements PERMIT CONDITIONS 1. All cells lor inspection shall be made 24 hrs. in advence - phone 259•8815. 2. All work shell be peAormed in accordance with this permit and current City of Everett Design and Construction Stendards and Spedfications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. Approved for Construction Date FINAL INSPECTION Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259•8815 Dale ��L� �� r�� �1�0% �C � �/�'EQ ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and seve harm- less lhe City of Everett from any and all claims lor damages, costs, exnenses, or causes of action that inay arise beceuse of Installetion a�d maintenance of the improvement or other right•of•way use herelo applied for and further agrees to remove seme upon notice Irom the City a�d to replace public property damaged ihereby. Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIi 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 DAYS DURATION.