Laserfiche WebLink
. <br />�"'""` APPLIC.1'�ION FOR PUBLIC WORKS PERMIT <br />e T� o� P�,�� ��a.�Y w�,� ,�k ... � <br />PRESS HARD - YOU ARE MAKING COPIES pERM1T NO. _U� <br />PUBLIC WORKS <br />EVERETT, WASHINGTON —�� BLDG. DEPT. NO. <br />�WNER ❑ AGENT DATE a <br />APPLICANT/FIRM REPRESENTED �� � hr � � T�� � v2 <br />i <br />ADDFiESS o�SC%�/�So� �/JA/Y/� CITY �v�i'F'/�TELEPHONE .�5� -l�'_�� <br />HEREBY APPLIES FOR PERMISSION TO �N"% ���P �f`� r� ��''� Fs_ si S�=�a� <br />i'� /"/G G� f�/TS rd rY/ � � s .o�I.S' �//,v TS - <br />AT THE FOLLOWING LOCATION �% v� �l/�� aSUG G�+'%7'�� P'v� ���p � <br />Attach five (5) copies of preliminary plans for proposed work Draw to scale and show the following as applicable: <br />` Property lines and street identity. ' Topographic changes requiring cuts and filis <br />" Outline and dimensions of existing and other than normal foundation. <br />proposed structures. • On-site drainage systems when required. <br />• Existing and proposed utiiities. � Erosion control methods when required. <br />• conforl�nw nf a6uttina riaht of way. ' North arrow <br />�U7hVI,I1V1`I,Ji . . .._—^--..--.-� ._.. __ __....... . . _ . . _ . . . <br />.I. : ; :Mi4'.x, ' i.�iioi�-i oF .5�vcu�n�K i5 4' <br />- - . . . . . . . P�-aR���u. . .WA�i�, <br />.Z, , .No, Lt4HTtaU U� APPUR�uAuGtS ���� <br />�__. -• -o� :T.t%E � -C-XL577�U6� � Sl06i.vA�-K� ,4 i�Y <br />.....11�5'ri.lrlL-.D � W EST. . d.F. TN E � 1 DEW A LK <br />.. ... <br />: . . . .D�.R'Gc�'I[�1�AL � Nb F�oD. . LAMPS. <br />. ,.. . ; <br />,. .� . _ .. <br />,. <br />:: .:,._.: : :; .::. . . ::: : <br />. ,. .. . <br />_._��_ ;._. _., :_. ._._. . . . <br />�... . . .� . <br />., . ... .. <br />......�. ,. ; .; 1. , <br />_..,....�. .. � ,.. <br />gG—TW E.EAI <br />:cvRB �uu: <br />ae . �,��.nwED CAS� cF <br />LI QH�'11�4 F 1.XT�RC-5 ... . . <br />sHA�� BG-. . .NoAil. - •'. . . <br />/ .... .._,�. .,�� <br />� _: � ':-; . <br />._ _�. __ �_ . . . . . . <br />-�- -"—' *� '- "-' '- '- �—� The undersigned owner hereby aprees ro holA end eeve hermleen <br />• � • • � ' ' ' ' � ' - � - ' � � � � ' � � � � � IM1e Gry ol Everett rrom eny ana eu cte�me lor Aem�pe0. coste, <br />� ' ' ' ' � � � ; . . � _ . � . � � , , � , . e•Pe�sea, or ceuses ol action thet mey atl6e becNse ol In6lell�llon ' <br />''�'����!� � and maintenance al Ihe imp�ovemenl or ot�er riphPobw�Y use <br />� _ .... . . . . 1 . . ... . . . . . . . . ... . . . . . . . . <br />V . . . . . . . . . . . . . � . . � he�eto epPlied lor and lurfhar egreen to remove e�mn upon notice <br />Irom Ihe Cily and to replace public p�oparlY dameped I�ere6y. <br />� �'� / _ ' �r_ . _�. <br />PERMIT IS VALID FOR 1 YEAR <br />EXPIRATION <br />ACKNOWLEDGEMENT OF CONDITIONS <br />—� � e' i� • „-� �-i _ <br />SIGNATURE OF APPLICANT ' DATE � <br />CALL FOR INSPECTION <br />POST ON 259-8811 <br />JOBSITE 24HRS.BEFORECONSTRUCTION <br />