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r <br />everett qppLICATION FOR PUBLIC WVORKS PERMIT <br />� TYPe oi Dnnl cleerlY wit� Ink 1 ,� . <br />PRESS HARD � VOU ARE MAKING COPIES pERM1T NO. �� �x y� --- <br />PUBLIC WORKS BLDG. DEPT. NO. � JI9 �_9�i <br />EVERETf,WASHINGTON � /� (J� <br />❑ OWNER �'AGENT DATE � <br />APPLICANT/FIRM REPRESENTEQ ( <br />�i�'C�� n �� �c C->��.� — -- --- <br />ADDRESS `�n •�� - .�./"`� �� GTY `��� � LL�X.�TELEPHONE"��-� �3� G <br />HEREBY APPLIES FOR PERMISSION TO _(,lif� � v i� / p �""��L����- - <br />__ _ — <br />- - 2 ��' -f%, J// . _ _-�/. <br />ATTHEFOLIOWINGLOCATION -JD��_- -�"�`t-� � "� � -� --,— <br />Attach five (5) coples o( preliminary plans for proposed work. Draw lo scale and show the following as applicable: <br />• Property lines and street identity. <br />• Outline and dimensions of existing and <br />proposed structuras. <br />• Existing and proposed utilities. <br />• Centerline of abutting right of way. <br />CONDITIONS: <br />� 1�-iS�% � <br />,. � _... _ � , , <br />�1� � 4 (� DATE <br />PERMIT IS VALID FOR 1 YEAR <br />EXPIRATION <br />L <br />• Topographic changes requiring cuts and fills <br />other than normal foundation. <br />' On-site drainage systems when required. <br />• Erosion control methods when required. <br />• North ar � � <br />/�L. �� �S Le�-v li`—'�.e-.�.�'L <br />_._�— —�— <br />- - Sipnetu oIAPPfitanl <br />PE <br />ihe untlersigned nwner �ereby eO�ePs �o �olA antl nev! �ermlelt <br />the Ciry ol Evereit Irom eny enu eu CIlime lor AemeOef, Catlt. <br />e.uenses. or ceuaes of acbon thel may eriea beausa ol in�tdtellon <br />end mamlenenca �I Ihe improvemenl or othei rlp�4obwey u�s <br />harelo ap01ie0 lor and further ep�eee lo remo�e esme upon nollce <br />Irom Ine Ci1y en0 lo mpiece O�Olic proDerty damaped thareby. <br />A I�OWL C��MENT OF CONDITIONS <br />� -= -- � 4.�►�.a.�.�� i'�2 n � B:,L <br />�-- <br />SIGIJATUREOF PPLICANT DATE <br />CALL FOR INSPecr�on <br />POST ON 259•8811 <br />JOBSITE 24HRS.BEFORECONSTRUCTION <br />� <br />� <br />