Laserfiche WebLink
, � <br />, eV� APPl..fCATi ION FOR p:.BLIC WORKS PERMlT <br /> ���� Type or print cleatly with ink <br /> PRESS HAAD•YOU hRE MAKING COPIES pERM1T NO. �•� � L� <br />' pUBLIC WORKS � <br /> EVERETT,WASHINGTON 2 �,Z DLDG. DEPT. NOB���-£�9� <br /> ❑ OWNER ❑ AGENT DATE Z�"P <br /> APPLICANT/FIRM REPRESENTED _��ST�� � ' �W`�E��- <br /> ADDRESS � ���y ��'��_ #�� CITY ���r�TELEPHONE ZS � 7� 7 4 <br /> , 1 � <br /> HGREBY APPLIES FOR PERMISSION TO ZD .�12 C� � `1'(�d�TIL�rLJ 7� <br /> �;�'l.�TIlt�G- f-¢-f3(�S� <br /> AT THE FOLLOWIRG LOCATION DZ ` r��T� �� �J//���� <br /> Attach five(5)copies of p�eliminary plans for proposed work Draw to scale and show the following as ap;�licable: <br /> * Property lines and street identity. *Topographic changes requiring cuts and fills <br /> * Outline and dimensions of existing and other than normal foundation. <br /> proposed structures. • On-site drainage systems when required. <br /> ' Existing and prop�sed utilities. * Erosion control methods when required. <br /> * Centerline of abuttinc� right of way. ` North��row _- � ` %-" <br /> //yG v��� vG(i "" :��i\1 � <br /> 't SlgnaWreotApplicaqC <br /> PUBLIG WORICS PEF�MIT <br /> CONDITIONS: _ _ _ <br /> i <br /> � . , . . <br /> ; i. �aa:a ,�., .,�� :-� : �� ���<•�? a:. �;�,�y -,�� �� - ;-� ��a:-I-�G� <br /> , . . , 1. . . . � . � 1:�. �csnn�er-�c...Y� .� � . ca � .cqn...n � e �� � l4 � �1 ..cLt�. s�o�l� v-N.evt- .. <br /> �i . � � ' , j _�,G.P�3 Y . w�a3�- ��C. .a���O..r� i�.��P� — NO. c�r�Vf wC� Q�G�G9.i ,o... 1 � . . <br /> i � . .. � �` <br /> i _ .- �� .... . . . . -. �:J . `� . . . �G '^I�i�Uw��T1 �� . . � . . . � . <br /> ;' lo�. pe�v..;i-�r.Y �h7w� I G �`Ivay�, J <br /> � . . . . . . . . . . . . . . . . . �� � � � <br /> : 1 . . . . . . . . . . . . . . . . . . <br /> � . .. . I ��. . " ; . . . . . . . . . f . . . � . . � . . . . . . . . . . . . . . . . .. . . . � � . . � . <br /> . . . � .{ . . . . , . . . . . . � � � . . . . . . . . . . . . . . <br /> �I . . �.T. . .�� �. . .. . . . . . � j �—. ' �, -.. �-__._�.�:_.i._, ; . . <br /> _ _ _ ._. ' <br /> t . . � i . . . l _.... � � . . . V �. ._ . . . � .� � . . . : ; . 1 . . � . . . i . ' . . . . <br /> � . _ _ , �.� ._ . � ' . � � _ � _ . ' . . . : . . . . . . . . <br /> i � : . � � - .�t� : , : : : � � <br /> , <br /> � <br /> "--'�"�—��^ � �, � . The undersigned owner hereby agrees lo hold and save hermless <br /> � � : � :_� �- ` � �`- � i � . � . : � � . ihe Ciry ol Everelt trom eny ano eu clalms for damage., costs, <br /> . . � � , , � , , � j � , . , , , . � . . . . expenses,or ceuses ol acHon�hat mcy etlse because ol Inatelletion <br /> _ , ._ , _, � , . . . . . . . . . . . . .. . . . . . . . end meinlenance ol �he improvement or olher righbol�wey use <br /> . . . . . . . . . . . . . . . . . . hereto apPlied lor and furiher ngrees to remove seme uDon nolica <br /> . . . � � Irom the Cily antl lo replece public propeAy dameged therAby. <br /> , . . ,!!I<((� h/-�1 ` V � <br /> O FORCONSTRUGTION f DRTE ACKNOWLEDGEMENTOFCONDITIONS <br /> — �? — S � � '� � c�,�.G � � ZIe.� >- lv"83' c3 <br /> AP ROVED AS C ST UCl"C �TE S GNA F� F APPLICANT c DATE <br /> PERMIT IS VALID FOR 1 YE/AR p�gT ON CALL FOR INSPECTION � <br /> 259-8811 <br /> EXPIRATION �`'� � '� 3 JOBSITE 24HRS. BEFORECONSTRUCTION <br /> � <br /> �� <br /> � <br /> i � <br /> I <br /> � <br />