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�� �ty � <br /> - ,4 _�.- _, -7�.� / <br /> Date �-�-92 �'�+' � � .,�, �•,,��.��..,�,�,. _ �_L c-S[a <br /> ,�„� o�w • �1276-__.—_-- <br /> ApPhcntioa(rn <br /> PUBLIC WORKS PERMIT '�°`""`�;°""" --- _ <br /> r��.�,.. s <br /> �.,,A�,����o�,.,,, s_ <br /> E��i'tl T�1 ��(TI�J(; t�- a_i_�,} �,,.���o�� s ��— __- - <br /> ��x Frml or Typu Only <br /> C H <br /> AHtn <br /> rri �3 l,yle G. Nlank PO Hox 2266 Evere[t WA 98203 355-4i25 <br /> KO Owner MPilingAtldreSs Cdy LP Phone <br /> H� <br /> 'O NH OwneT <br /> H �,� pnplicam MnilinyAAdress City Zip Phone <br /> T L <br /> [ij y <br /> Describe Proposed Wor4. new SFR <br /> ° �g __ <br /> y�V � <br /> � H� -- _ -- _ _ W � <br /> �y y ��� � p, — �, ��p 2-t�L�t�_s��u-9z �" { <br /> O H Pro�ecl Adtl•ess UI Nnownl _S,1�j�-C1 — <br /> n �N ( <br /> Altich Ir.ur ldl�opies ol plans br propo5ed work- D�aw in sraln �iid no�e IhC�ollowiny a5 aPplicable � <br /> • P�oper�y L�neS • Centorlme o�sirrei <br /> y �� •Oulline nnd dimensions ol au e.isl�n9 an� • Indicate Norlh ' <br /> proPOSCd SIfUCWrCS On�hC Iui • ShOw.lny proPoSeA 9r;ltl���.{�Chdnq05 � <br /> • E�iStinq xnd proposcA ulildies • Show mea,uremenls M � <br /> W ; <br /> DO NOT WNIiF AELOW iH15 Li4L A � <br /> PERMITCONDITIONS ~� ' <br /> 1.All tells for inspeclion shall be matle 24 hrs �n ndvanr.e�nhone 259•8810 � <br /> 2.All work shell be podormed in accordance with this permil and currenl City o�Cveretl Desian antl Cons�ruchon <br /> Slandmds end Spetilicatlons. . <br /> f� � �.Call Location Undmground Service 4B hrs.before you d�p TOLL FREE NUMBER 1•BOO•424•5555. � �� <br /> � �� � <br /> O I <br /> �µ �� � <br /> �� � O <br /> a <br /> (^ —� nc�.�anrn t oci �+�r�t ur ciiNonioNs <br /> � I n� , itic i.,�qnrd���nri,xPPlicin I hcirbY n{7ic��5 lu IinIA md�dve h��nn� <br /> ;' � �—' _ _-. ----'----- � -----. . -- - -- - -- � I ss Ih�. GIY ut Evuetl Irom �nY ����d �II daims lor Jim�u�es. cosis <br /> � _� — ���L---,��`� y` / /� I ��pe•n �ti o� cnuses ol �ciwn Ihi� mnY nnse because ol ms�allTtion <br /> � anJ nn nl�•��n�+rr ol Ihr impiovem�nt ni o�her nghl-nl-way use hereln <br /> _ � ppi� I Ini and lurll�• d���ors I�. n•inuvr SHme� uP.�n notu'r Irom Ih[� <br /> AVP�ovPd IOf COnshm:bOn �dt.. • C�I1 ��m:In �rPLn r P��bm PruPr�ilY tldm.tyrA Ihoi�hy <br /> I� —�� <br />