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1 <br /> � <br /> . o�. <br /> � <br /> , f � � <br /> j w / APPLICATION FOR PUBLIC WORKS PERMIT <br /> � Type or Drint clearlY wit�Ink <br /> PRESS HARD-YOU ARE MAKING COPIES pERMIT NO. �/�9�� <br /> �� pligLlC WORKS - <br /> I EVERETT,WASHINGTON BLDG.DEPT.NO. <br /> ❑ OWNER ❑ AGENT DATE ��' 2� � �� <br /> APPLICANT/FIRMREPRESENTED `'� nLL�'�� �` --�-+ �~ `� I <br /> ADDRESS � o / � � °i� �'�� --CITY �✓ • TEIEPHONE 2���� <br /> HEREBY APPLIES FOR PERMISSION TO 1��)� �-��. � ��'`����vC� ��P�^C� <br /> � �� �7 Ae � C�� �-1 2 �i �`n,t;t�� \' ���v � � � <br /> ` <br /> ` ATTHE FOLLOWING LOCATION �� � J n' J` �--L���—— . <br /> Attach five(5)copies of preliminary plans for proposed work Draw to scale and show the following as appliceble: <br /> • Property Iines and street identity. •Topographic changes requiring cuts and fills <br /> i ' Ouiline and dimensions of existing and other than normel foundation. <br /> proposed structures. 'On-site drainage systems when quired. <br /> I ' Existing and proposed utilities. • Erosion control ods whe quired. <br /> •Cer,ter!ine af abutting right ot way. • North arrow <br /> , <br /> is re nvo���an <br /> I - PUBLIC WORKS PERMIT <br /> CONDITIONS; <br /> i . . . . <br /> . : :I. S+a�rcase. vnti:s}. be w.o� � � C�oncrc�e. is no� aPP%�ec� : <br /> , : ; . . <br /> . : . : �. Measurew.e�� o�_ aNa�r�: draµ.�n� ,a�c aP Prov�J . y : : <br /> . . " � - • . . . � . , . i : , ; <br /> I : : . , : r .f <br /> � ' ' : ; . : . : � : : ' : ' : : ' . . : , ; . � . . . i <br /> ._. . , � � . . . . ! � <br /> � . . . <br /> I . , . . . . . . , i , <br /> . .I � 4 ,-1 _ `� ; ' . . , �--�-- . . � _,� .-�--. � . . �� .. <br /> , 1 , . , l .rt�. ; , . . � . . . . . ; <br /> -r �. I , . � � _, � :a _ �r . _l —•. _ 1 _ . ;_ ..� . _ � _ � . . <br /> ----:y-�---�--� :-_-� -r . , . , . <br /> -� , . ; 1 � : � . , . <br /> �i � � � . . i � .. <br /> � � I <br /> '�-i--����-'�'-�j . 4 r ' The unUersiBnetl owner hereby aBrees lo hold and save hermle6s <br /> � ' '' '���' ' � ' ' � ' ` l � . ' , , � , , � Ihe C11y ol Evarelt trom eny ena all clelme lor OameOea, coet0. <br /> 1-'- ` � ' � ' � � � � � � • � BxpBt18¢S,Ot C8u6B8 0�2LIf0l1�h91 RIBy 9f180 bBCBUlB O�It16�Bl1l�IOn <br /> � � ' ' ' ' � � � � - � � _ . _ .. . and maintenence ol tha improvemenl or alher r10h4o1-wey uee <br /> � �� -� � � - � hereto epP��eE lor end�uriher aqreee ta�emova esme upon notice <br /> �~ . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . Irom the City and W replace ublic propartY demeped thereby. <br /> I-� /( Z/ � ��� � �� <br /> �-�/-� /O- <br /> O D FOR C NSTRUCTION � D (TE ACK WLED M��! , .CO 1710NS � �f'/ � <br /> � `� ZJZ %� i �%� �l/ <br /> AP VEDASCO RUCTED DATE GNAiUREOFA PLI DATE / I <br /> PERMIT IS V ID FOR 1 YEAFI CALL FOR INSPECT � <br /> i POST ON 259-8811 00 <br /> � EXPIRATION _ ��BSITE 24NRS.BEFORECONSTRU ON I <br /> _ - -- -- <br /> -- i <br /> i <br /> I <br /> — -- -- — - � <br />