Laserfiche WebLink
' ' <br /> ; ', <br /> "`"` APPLICATION FOR PUBLIC WORKS PERMIT <br /> � TYPe or Grint cleerly wll�ink <br /> PRESS HARD•YOU ARE MAKINO COPIES U � <br /> PUOLIC WOFKS PERMIT NO. o`� �� <br /> EVCRETT,WASHINGTON BLOG. DEPT. N0.__ <br /> �OWNER ❑AGENT DATE G ' � ' z' � <br /> APPLICANT/FII7M REPRESENTED .__ __.]�R4�C_�____tWD�RSp1..� <br /> -------�� r -19-5-3 <br /> ADDRESS II IS ��I�5C1�(>� I�� CITY �U[�r1't_TELEPHONE ���"y�SS <br /> HEREBY APPUES FOR PERMISSION TO P��� �'nr,�C f.�' �K P61L 2E'r P��v�N6 <br /> W►-t�t� �__ <br /> ATTHE FOLLOWING LOCATION _� � � CASCt�D� L�2. <br /> Attach five(5)copies of preliminary plans for proposed wark.Drew to scale and ahow the following as appllcable: <br /> ' Property Iines and street identity. • Topographic changes requiring cuts end illls <br /> • Outline and dimensions o(existing and other than normal foundallon. <br /> proposed structures. ' On-sito drainege aystems when requlred. <br /> • Fxisting and proposed utilities. • Erosion control methods when required. <br /> ' Centerline of abutting right of way. ' N�qh arrow <br /> \) � l��Nllil.�_ <br /> � Siqnalure ol Applltenl <br /> coNoirioNs: PUBLIC WORKS PERMIT <br /> y � � <br /> jt f t_vn � � ,�< �. � � �,�.ti ��o s �x� ���� �t�y�., � <br /> 1-:""�.-:} : P P r-,1 / ,/ ,� d� •C;5 .c �- -o � / c-��� <br /> _ �.. rw c � ��� r �., J r� '� � <br /> � j-. �ro ��c� e� c. _�. tl �o �,-,.1- � s � Iac ���� �-- <br /> � ..��...• �1✓ C�� I I � 1 � 'C.1 ��/�/!a:V .fL�C-'�ILL'1 �/1J/O`� <br /> �` � in <br /> �. _ �� 7S�r�ef- iP,/�. rn.� 6� ��...�� <br /> �_.� : <br /> �"� <br /> i .C-- � i7 /C� u.2�.-1' in �.l f.� v�s�•� �r�� � J.. <br /> t _ �__ ,._.,.! <br /> ._ .�_.. . : I 1_ <br /> ;_I_.i_� . <br /> ._.' i <br /> �_ � <br /> •._�-�i 1 J I.. i- 1 ' �.1_-�-L� . _.:....i. _ .I._.! _L...i._j... iha unEars�pned owner hereby eprees lo �010�nA�wa huml�io <br /> ' � �� . � . � . : . . . . _�. I�e City ol E�eren trom eny �no ui cl�lm� for d�m�peR �o�t�, <br /> � . �' � -•--�� a.vereee.or caueae ol action IhU m�y�rW b�cauq o1ln�tdlNlon <br /> � -�� �nd moinlen�nce ol Ins Improvemenl or oth�r tlpMrol-wry uu <br /> , / hereto�DPlled lor end lurt�ar�pree�lo removs��me upon notk� <br /> ' / from ihe Clty enA ro roplace Oubllc proporly d�m�pa0 thenby. <br /> ? �y -�i"_ y/�> _�� � <br /> PPROVE F R ..:;N U DATE AC WLED6EMENT OF CONDITIONS ___ <br /> � '' -- /-�G',fis ���� �M..tl,,c,v�otit �I - 1 U-E�Z� <br /> ` 7�ROVED AS C ED DATE SIGNATU E OF APPUCANT DATE <br /> PERMIT IS VALID F R 1 YEAR pOST ON CALL FOR IN8PECTION <br /> 259-8811 <br /> j EXPIRATION JOBS�TE 24 HRS. BEFORECON8TRUCTION <br />