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.� <br /> _ � <br /> °�� APPLiCATION FOR PUBLIC WORKS PERMIT <br /> Type o�orim cieeri�w:m�nw / <br /> PRESS NApD•VOU ARE MAKING COPIES l��\ <br /> PUBUC WORKS PERMIT NO. `!� 3 �� <br /> EVERETT,WASHINGTO�� `[ <br /> ❑ UWNER ❑ AGENT DATE �'.y�_' -�C'' ��J�j� BLDG. DEPT. NO.__ _ i <br /> APPLICANT/FIRM REPRESENTED 1/ _ �� �/ ���� �y �- <br /> % - <br /> // , ! _ - - ---- <br /> ADDAESS __�7(j i�--�sJ;c_Ll���----. CITY /.=6�I`� � �- ' - <br /> -- -L��TELEPHONE �� �� i S <br /> HEHFBY APPUES FOR PEFMISSION TO ____._�1y��'1��1'F __ _�}f'4�� •,•_ i r ' � <br /> , ----'�-.d�,�.E <br /> .� /<< lf- S ,!�` �c���fi�/.��r,- .h ___ '�'`Y— <br /> -- -- - _ -- - _—��cc/----- <br /> — — ----- <br /> AT THE FOLLOWING LOCATinN _�� ��'_"__7� �.� _ ( , �) 1 '�� <br /> — �.�_/'-L—!'__��r <br /> Attach five(5)copies of preliminary plans for proposed work. Draw to scale and show the following as ao�Hcabla: <br /> • Property lines and street identity. • Topogrnphi� changes requir(ng cuts r id fills <br /> ' Outline and dimensions of existing and other than normol foundation. <br /> proposed structures. • On-site drainage systems when requlred. <br /> • Existing and proposed utilities. • Ero ' control methods when required. <br /> ' Ce�terline ol abutfing rr�ht of way. orth air w <br /> � <br /> ... ��---��� . ._' <br /> Sipnetureo��PPlic�-----' -- <br /> coNnirion►s: PUBLlC WORKS N`ERMIT <br /> ;/V���, T/ ---� <br /> ,�_ ,. .'�' jlil`y.. �, :i..:'. : �� ��'�'. �i EFUS�om m� sv <br /> � / M�1t`RJwrt� M+oj' <br /> �'� 6<•tGrr n Pt[fi 4'r wyr�W�// /� <br /> �\ . <br /> .. D: /w f 1`ef'/��✓ /H� /R//H�Q. i/n.•W <br /> � ' .. 7'� O`�f J4 YrJ��Ccr,p�1 li � 'iSF� <br /> n ,Q c�, _z-..�P e��;e.e rf a ., e��0 <br /> �= > —_.�--.. <br /> � �� : + a��.��r . <br /> � �-,_. <br /> � �. I ct. :1�.�lri, �. d � <br /> �y �MfJ /� Na <br /> �ry i �_// <br /> ,�-� / .. � � �Ti�IG" OiI� �k L�L <br /> r �� � �%fh� o F K�,.�q� a.a� �.r..,� /�� , <br /> n I ,F��o� c,/,,c., .�1 ..// <br /> ��,r�++ i� I�S a�tl r �-� MrJ,� f>c <br /> rJl�MS4 A�M./ ,�Cbf�l !-PvnV��vl\ \ ��S I" V71P SR T'/S�V�ICc'riCil <br /> L . a�v�i�e �w, in�^�-I�� <br /> YI O � O T jp� � Ct � I H� � S ��7he untlereipne0 owner heraby epraee lo holtl ar tl eeve �ermbu <br /> _� ��� ih0 Clly ol Everell �rom anY ana an cialms lor tl�ma0s4 co�IR <br /> A I Q W P� e+Peneee or ceuee6 0l action that may erlee bpau�s pl in�l��htlon <br /> ��� � and mainlenenca ol the Improvament or at�er tl9h�b��M'�Y u�e <br /> �� � �erelo rpplied lor antl lurt�er epree� lo removo�ame u <br /> � pon nouce <br /> �j 7 .! �"' , Irom Ihe Gry entl to replece public property tlam�p� Ihsraby. <br /> C(! �� L I <br /> �H , f QU S RUCTION 0 E � <br /> � AC EDGEMENTOFCONDITIONS <br /> /� : /�. �/. , � <br /> �� / e��/� <br /> �� � _' <br /> APP'ROVEE3�if3 O F U�GTE�+ l ( � !`--� ' U-LI!_ ��1CC� <br /> DATE 9H3 A UREOFAPPLICANT - ppTt <br /> i� IT IS VALID FOR•� CALL FOR INSPECTION <br /> Z urr S POST ON 259•8811 <br /> EXPIRATION 1�c,� ° '_ JOBSITE 24 HRS. REFOREGONSTRUCTION ' <br />