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<br /> """" APPLICATION FOR PUBLIC WORK8 PERMIT '
<br /> � Tro.«vnm d•.nr wim ink $�S �
<br /> PRE88 HARD-VOU ARE MAKINO COPIES
<br /> PERMIT NO. t�
<br /> PUBUC WOaKS � '
<br /> EVERETT,WASHINGTON BlD(i.OEPT. NO.�O 'Z �°�
<br /> � O OWNER QvA6ENT DATE x ` :- `f - S L ,
<br /> APPLICANT/FIRM F'FPRESENTED _!'� e�'_t.[_-1-_s"3_-��/+1���1C' —
<br /> ADDRE3S _�`��_`1_—�2..��'tiuin e d CIT1'�/�.L�'.��l� _TELEPHONE Z'��• 3 S 3� i
<br /> HERE6V APPLIES FOR PERMI3310N TO ����7�'� Z J � �.P l ✓E a. A ./ 0 F F
<br /> _�(� F � /�✓o�P �N �F �S��:r ����.�r,� ���KEiP r vi �G/�v�,� !
<br /> ATTMEFOLLOWINQLOCATION ��JP�K�/ S/o __ _ ,
<br /> Attach five(6)copiee of preliminary plana for propoaed woi k.Draw to scale and ahow the folloW�np���pplicable:
<br /> • Property Iines end etreet Identiry. • Topopraphic chanpes requirinp cuts and illls
<br /> •Outline and dimenaiona of existiny and other than normal foundadon. ,
<br /> propoeed utructures. • On•eita drainepe aystems when requlred.
<br /> • Existiny and propoaed utllitles. • Erosion control methode when requirod.
<br /> •Genterline�f abutting right of way. ' No h arro i
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<br /> Ipnitw�ol APYllunt ,
<br /> i PUBLIC WORKS PERMIT
<br /> , CONPITIONS:
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<br /> , ��� �.� i , , � . , , � , , , , , . � , , , ; T�a un0eni0�ed owner henby�prou to�old�n0 uw huml�u
<br /> : � . . � . . . . . . . . . . . . . ths CIIY ol Ev�rru trom �nY ma u� N�Im� lor 4mp�R wNR
<br /> , . . � , . . . . . . . . . 0AplO��t,Of GUN�01�CIWl1 Ib�1111\y�/IN WC�YM OI IM��II��Wl1 I
<br /> �-.-. . _ . . . . . . . . .. . . . . . . and m�inten�ncs ol IM Imprw�m�nt a oth�r rqAtohW uw
<br /> ' i . . . � . . . � , . . . . . . . � haroto�oPllaA lor�nd IurtMr prN�fo nmm�wm�upon notlp ,
<br /> i . . . . . . . . . . . . . . i Irom Ihe CItY mA to npl�es DUDI� prop�rty d�m�pW tMnpy. .
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<br /> � AP /1' F R N �CTIO � / TE� ACKNpWLE�EMENT OF CONDITIONS ',
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<br /> . w+�-�i fGi�.)-,�� �; _ /��I�__
<br /> pHFj10 D 3 Cf)V5T(1 Eb r DAT � IS 6NATURE�CF APPLICANT DATE -
<br /> E�RMI�IS .ID FOR 1 YrAR pUgT ON CALL FOR INSPECTION�
<br /> _� J�DBSITE 25�•8811
<br /> � EXPIRpT10N_ 24HRS. BEFORECONSTRUCTION �
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