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P�L,IC WORI�CS P�Rt�lli PL�ICi4ilOIV <br />CITY OF EVERETT PERMIT S VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � wvuw.everettwa.gov/permits <br />I SITE WORK 1 RIGHT-OF-WAY APPLICATION INFORMATION � <br />DESCRIPTION OF WORK: <br />S.PFwatk, <br />❑ FENCE IN ROW <br />❑ DRIVEWAY APRQN / CURB CUT <br />�,JS�"A�La�1� � v.= wsaUlcw�'-t 1s;�c°S �R--o.�. �ai,vilL- 'Dw�1. '�c.....a,J Tli �-11`�1 <br />FT IN HEIGHT <br />FT WIDE <br />� ASPHALT / CONCRETE PAVING �� SF <br />❑ RETAINING WALL / ROCKERY IN RIGHT-OF-WAY LF <br />❑ RETAINING WALL / ROCKERY OVER 4FT IN HEIGHT <br />❑ CLEARING / GRADING / FILL / EXCAVATE <br />❑ CUT/BORE IN PAVEMENT (PARALLEL) <br />❑ CUT/BORE IN PAVEMENT (NON-PARALLEL) <br />FT TOTAL HEIGHT <br />CY <br />LF <br />LF <br />ACKNOWLEDGEMENT I have reviewed this application and confirm the information contained herein is t�ue and correct. Work done pursuant to this permit must <br />comply wiih current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviatrons must firsf be <br />authorized in writing from the Building Official before being authorized under any circumstance. I am fhe owner, or 1 am authorized by the owner of this property to <br />perform the work for which application is made, and 1 comp/y with fhe Sfate Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everetf Offrcial Use Only <br />PERMIT # <br />���,� � � , � �; � PW I6 0 � - o�-� <br />, <br />Owner/Authorized Agent Signature Date (Revised 90/92/2095) <br />f r�-1 l �S <br />