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r ..� <br /> � <br /> everett APPLICATION FOR PUBLIC WORKS PERMIT <br /> � TYPe or Ptlnl claBrlY wllh Ink / <br /> PRESS HARD• YOU ARE MAKING COPIES f;z/ � j� <br /> PERMIT NO. _j I _-__ <br /> PUBLIC WORKS <br /> EVERETT,WASHINGTON / /p BLDG. DEPT. NO.������� '� <br /> + O�OWNER ❑ AGENl DATE 6 Z_ U._y_ <br /> APPLICANT/FIRM REPRESENTED ___ Ldu�`S_-_1..e _�✓l-laY1lG__ <br /> ADDiiESS �T�a��.S�V_�e�L� _CITY �e��TELEPHONE ,2 �5'9��2 <br /> HEREB APPUES FOR PERMISSION TO __ YGvyOrl���n���]QyYlE=-�fi�y-Qr _�/i�� <br /> ATTHE FOLLOWING L CATION __����_.`J��,I1�� LYl -- _ — <br /> Attach live(5)copies of preliminary plans for proposed work Draw to scale and show the following as applicable: <br /> • Property Iines end street identity. ' Topographic changes requiring cuts and fills <br /> ' Outline and dimensions of existing and other than normal foundation. <br /> proposed structures. ` On-site drainage systems when required. <br /> � Existing and proposed utilities. • Erosion contirol methods when required. <br /> ' Centerline of abutting right of way. ' North arrow <br /> ��tyyq���wS31�6aC <br /> SlpneNre of AOPIIcent <br /> PUBLIC WORKS PERMIT <br /> CO ONS: <br /> - - � - �-+-� <br /> � ' <br /> � - � <br /> - - i-- - , � <br /> - 1- - , ��� -� � -t +-� �� <br /> - - 1 -.�.-.- �- �-»-.- fi - �-.� <br /> -+-,-- �L :� , -� <br /> , � <br /> - - - - +�� - -- ^1 }--�� -}-,-•- -� -�} + ' +- <br /> ' ' � rt1 + 1+- •-»-i i-1�- � L r -�' - _i i <br /> �-t _ _*.. _ _} -• i �. l- -�� + a_, i_} 1�. � ' � � <br /> � it _ + �. � }. _ , _ � �, : - . , <br /> . ti_� ; �_i .-�. � :+4 t� <br /> - � <br /> , <br /> -}} - - - �.. �-:-t �1 • , .- 1_ ��+ -,-i <br /> 1-1 - - - � �� - - -� + f ' t-�� -'+t -'-t� �.. �-1 <br /> 1 _ , 1 } � + :-� �- �- <br /> ' � <br /> � � -� - �--� ��. ,-�� . _ 1� � ! J <br /> . . <br /> � - - - --- �+ r , �_ . .. }_ . ._ .-.- � <br /> 1 . � ' � <br /> } t +- - � + �� _ i-�_ . . . .. . ._. , . i � • + � - r 1�.,. � <br /> 1_ _ _T ' _t_, _ _r_Y , T�e untlealqned ownar hereby epreae to nolE and uve �umlee� <br /> .j.. _ _ _ f � .�+ _ _ _ . _ _ �_ . 1 t�e GIY ol Everell Irom �nY entl au cwm� lor d�m�Os�, cwtR <br /> '�. . �. . � a- - � �� • 1�-�- e�peneen,or caunee ol acllon t�at mey ube Oscav�e ol In�I�IlaBon <br /> �nU meintenence ol Ine improvement �r at�er rlp�tcbw�y uoe <br /> - - ' - +�'1— "'�' --�� �e�elo epplie0 lor antl luriher apreas to romova tues upon notica <br /> _�� Irom t�o Cily end lo reol�ce oublie property d�mapeM I�ereby. <br /> � _� _jL <br /> � PPROV D FOR ONSTRUCTION ATE ACK WLEDG EN P CONDITIONS �: <br /> � _ ' 7 �`� �z � � e 6 2 8'Z. <br /> AP ROVED AS CONS TED DATE S TURE OF APPLICANT D�.TE <br /> PERMIT IS VALID FOR 1 YEAR pOST ON CALL FOR INSPECT70N <br /> 259-8811 <br /> � EXPIRATION JOBSITE 24HRS. BEFORECONSTRUCTION � <br /> � � <br />