Laserfiche WebLink
_' "'l <br /> . C1f`ar � L`� r�: rl � i <br /> °°°rc" pppLICA"�IOM FOR PUBl.IC WORKS PEFlMIT <br /> � TYCe or Pdnt tleadY witn ink <br /> PRESS HARD•YOU ARE MAKING COPIES pERM1T N0. � 2 �"V � <br /> PUBLIC WORKS <br /> �EV ETf,WASHINGTON �1 L BLDG. DEPT. NO. 1 <br /> OWNER ❑ AGENT DATE _C__7_ y/ --- <br /> / � <br /> APPLICANT/FIRM REPRESENTED _-'�7-�•=�=--�r—` _"]-________---_-- <br /> ADDRESS �'I�� <br /> �!'rrlr-! �•� �- __CITY ��-C: �� _• —TELEPHONE `�_� '� �l I <br /> HEREBY APPLIES FOF PERMISSiON TO - ----' <br /> -- --- - — r� -Yl`_------ <br /> / � �- +'f=.-,, � -. � <br /> ATTHEFOLLOWINGLOCATION —:riLL—=-�-�`�, ` �—�'����'`��t �� ��u�� � � �~� � <br /> '� 73�' —,f�.'f'vic..� L.tnt. <br /> Attach five(5)copieu of preliminary plans tor p;oposed work.Ura�a to scale and show the following as applfcable: <br /> ' Wroperty Hnes and street ldentity. ' Topographic changes requirfng cuts and fllls <br /> " Outline and dimensions of existind and oth�er than normal foundaHon. <br /> proposed structures. ` On•site drair.age systems when required. <br /> * Existing and proposed utilities. * Erosio control methods when r quired. <br /> ' Centerline o( abutting right of way. ' NoAh q w <br /> �c.__2�_�=--3� " _ <br /> Sign IWe ol Appilcanl <br /> co�aoirioNs: PU�LIC WOR�CS P�RMlT � <br /> 1 � ' s _;. ' t . <br /> ( � = ; <br /> / �r�; �v�nc� r. —�m� y..� �,<�hc%f � �� �� v� �i `> T- �._ <br /> � �'` <br /> Iv�4t�v�` c:�vtr'.\� <br /> �p �'1Jf�.� w��-�- l.� �C�'� ���_.,�'flti� i',- 1�^���ul�`-" C� l �ti��c�.+Pflc�.�' <br /> ot. <br /> 3 -� !� \ k�. f, � �.�t�,�, .� d «1 � _ ( ,�.,�•z <br /> � <br /> �-.Oc<l.,i.i.. u�l !.;�: be <br /> �'- � � .- ,..j����/��cl �_� /7 ( � CriiPCf" i •..� <br /> � l"t'S/O rl �.�f�Pi ��'L� /f l/1-1 I / � � i <br /> f ; : ' � <br /> O�i�. ��i.�-'�c��uJ� -`�i ,i�»��/C'� �l�� :5���t 7iv:-r �� �_..:. , <br /> 7, <br /> /�� iPi;'Iv� c�'i !Cl S• , : ' <br /> C�;) v ;! S� . . <br /> _ - ._ . .. <br /> � . 1� � ' ' � � The undareiqneA owner �ereby eqreee to hold end save hermle�� <br /> .:. . � . . . .. . _..... . ._..� <br /> - �. , _y..�_ tne Cuy of Everen trcm eny ana eu cwma lor Jem�paF coe1�, <br /> ;� �, i_.L .......�_-....... erpeneee,or ceueee ol acllan thal mey erlae bsuu�e ol In�ldlotlon <br /> '� • . . . . �. end meiotanence ol t�e Improvement or other tlahlrot�wny ws <br /> �areto apC�ied lor end lurther a0�eee to ramovs��me upon nolka <br /> /% Oom Ihe City anC lo repiece Oublic yroperty �1Ame9� �harebY. <br /> �--� I <br /> /� i� `J_x: y � I <br /> Ly�� �' / � _ � � ACKNOWLE GEMENTOFCONDI 10 7 �- <br /> ` AP RO ED FOR 00 S R CT'ION DATE , ,�. �+ <br /> - ��-�)�� <br /> ` 9 g3 l^__ _ _ ., <br /> A OVED AS C NS7 TED DATE 91 N TUKi OF APPLICANT DATE <br /> PERMIT IS VALI FOR YEAR CALL FQR INSPECTION <br /> POST ON 259-8811 <br /> JOBSITE 24HRS. HEFORECOMSTRUCTION <br /> !. EXPIRATION <br />