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� S r t� E E T T �R E E P E , ri" I I everett <br /> � � � AND APPLICATIOPJ ' . __ . ' <br /> ' � <br /> �a0�f 6fb4aV1 {4u�i�'tlC.. . <br /> 1�rOP. L C T�pN ADDRESS ' � <br /> 2 0� (,�SNO �ile� C�o�taow��+�iuw� ��rrt�ienl, ' <br /> 1�2iR:5cnl �A�f�f�cJS f}'�$em�F' 'v�^�tI1G.'4 ' <br /> NAht OF LEGAL�WNER OR AGENT <br /> 355- 977(e saw�. � <br /> BUSINESS PHONE N0. HOME PHONE N0� <br /> PERt�IIT 1SSUeD SY ATE EXPIRATION DATE p ' <br /> R-0-t4 USE PERt•IIT REQ`D? YES� NO___ '�CONSEiJT TO REMOVE" REI��U? YcS_NO_,_,_ <br /> WORK i0 BE DOi�E: <br /> 7RIM PLANT�_TRANSPLANT OTHER <br /> . � <br /> REASO�! FOR ti�ORK: <br /> , <br /> CQNSTRUCTION�ISEASEIINSECT SAFETY._ STREETIUTILITY DAMAGE � <br /> OTHER �SPECIFY) � <br /> TREES TO ���D: �p, � n � ; <br /> Z" ?f <br /> SPECIES Fl.n��e,a:nc� Ci1CR.R�_ SIZE�0. CONDITION <br /> SPECIES SIZE__JdO. _CONDITION <br /> SPECIES SIZE_J�10. CONDITTON y <br /> SPECIAI CCMDtT10NS��K�• �i5S0� �1i� 1 ►��1�0� irer� S • <br /> . t <br /> � 1. Pei�rt:itee,,must comply with applicable conditions of Section(s) > <br /> ���� (°t inclusive of the itunicipal Code of EvereYt. � <br /> 2. Only those trees or plants specified on this pern�it shall be used, All <br /> permit conditions shall be Yollo�ved. F <br /> 3. Nhen removing public trees, trees shall ae removed Uy the root, all holes ; <br /> � completely filled, and debris removed, all at tt�e permitees expense. i <br /> 4. Adequate barricades sha21 be provided !or public safety. lighted :�t night. <br /> i Sidewalks must be kept clear at all times. �; <br /> E 5. Permit epplications must be made to the Building Department, City Hall, or <br /> 9 the Park Department Park ltaintenance Division, .Forest Park, at least two <br /> ! business days before starting work. No work aill begin before this permit <br /> is issued. , <br /> ' 6. aithin iive bueiness days of �vork completion. notify Park liaintenance ', <br /> � Division office !or �inal inspection. Sliould work not be completed by the <br /> expiration date shown above, a new permit application is requized. . ; <br /> � �' ������������' ���������'���d'"-�� � <br /> ' ; <br /> ; FOR CITY USE ONLY <br /> PLANTING STRIP x MEDIAN <br /> PARK DEPARTMENT: RECOMt9ENDED�,"_ NOT RECOMMENDED �ZII�% <br /> STREET DEPARTMENT: RECOMMENDED ''NOT RECOMMENDED_ REASCN ' <br /> UTILITIES DEPT: RECOMMF:NDED_J�OT RECOMMENDED____ REASON <br /> TRAFFIC DEPT: RECOMMENDED_NOT RECOMMENDED_ REASON � � � <br /> OVERHEAD OESTRUCTION ' <br /> INSPECTED, BY: `�IATE_ ACCEPTEA_.�tEJECTED, <br /> ACTION � <br /> � <br />