Laserfiche WebLink
i _ . <br /> �""e1 A�PLICATION FOR �UBLIC WORKS PERMIT <br /> �� Typ�or prinl clendy wilh ink <br /> 1� PFESS HARD-YOU ARE MAK�NG COPIES �j�•Z/�j '>`-� <br /> PEqM1T NO. __ _—__—_ <br /> PUBLIG WORKS <br /> EVERETf,WASHINGTON �j BLDG. DEPT. NO._ . __—__ � <br /> �OWNFR ❑ AGENT DATE lU l �3 '�`• � <br /> APPLICPNT/FIAM REPRESENTED �LL[,S �T7)ZCj .,/�_ _. -_ _ _-__ ---- ._ -- . - ._-_--__ _--- .—--. <br /> AODRESS�S!C•_�������=�V�y---- CITY «��" —TELEPHONE3�;�yy'Z __ <br /> HEREBY APPLIES F07 PERMISSION TO �/VS/_BfL�_�S�_G(f��.CdN����`�^���Z���y�— <br /> AT THE FOLIOWING LOCATION �_(2f—D���w�7��yS���s /.'-'�-�V.PfaIP�+ e �4� S . W___ _ <br /> Attach five(5)copies ot preliminary plans(or proposed work.Draw to scale and show the following as applicable: <br /> i ' Property lines and street identity. ' Topograohic changes requiring cuts and filis <br /> • Outline and dimensions oi existing and other than normal foundation. <br /> proposed siructures. ` On•site drainage cystems when req�+ired. <br /> ' Existing and proposed utilities. 'on contr I methods wh��n required. <br /> ' Centerline ot abutting right of way. f No ro / <br /> .11 r�(� --- — ---- <br /> Sign:iNrc of Applican' <br /> CONDITIONS: �UBLIC. VI�O KS PER IT � <br /> �. l�I�e.� -�7elE� l'Q>C.++P.cE' a�.^n. jD noT �o b.� C�rnfrJ', <br /> � � ��Ih� +. <br /> 2. Kwj --Ec' drn�Ha�e ,m..�l �oe eo.• o.� �I,e �� <br /> � �'J ° �.n e o 1.n�0 �� I��W c:•eu�r�n5 <br /> 3. �n� c�av..N`e v c_s � -d \ <br /> clue � r-....s-l; ..�� ,o.. t.,KSH be ��p�,r�� b. ` Li,,,1�e/ <br /> / ,�Pb�if -�?tc�Cl O�w�/i fnub��c, /l��V �m ;f/1iS au..3'�«c�ro.�, 5.✓-G <br /> �S ��� �7e c'�EYi`.infi ..� c�ln/y . <br /> - A�� � .� � /� <br /> 5. us}' w.�dr: sc�� ✓,�c ;..��ve bc F ./e i,+� � �r�rui_ . <br /> The undersigned cwner hereby agrres b �cid and save ha�miea� <br /> Itie Criy ol Eve�elt tmm any anu au Clarn:� br damepes, cosis, <br /> eKp?nsr.s,or Causes ol aC�ion Ihal may arise toGnu9e ol in5�8110�i0n <br /> end main�anance of Ihc improvnment or o:her right�ol-wey usn <br /> �orelo appGaA lor t.�tl lUrlhef agrees to remo�o s:.m0 upon notite <br /> /�; Irom the Ciiy antl to �eplece public propaity tlemaPetl theraDy. <br /> _�-i .p/, y/ / <br /> i�>, O/�/Ci / ' ���- ��� %��Z� / <br /> .A—P/P'��O/V�� OR(�.O�NSTRUCTION DAT ACKDi WL GF T CONUITIONS <br /> J � � J C�/�d. '.L 0 � %77 � 1 �� <br /> ��...X.� 1 �� <br /> � APPROVED AS CONST TED ��:�ATE SI A AE OF AP LICANT DATE <br /> PERIVlIT IS VAL1 FOR 1 YEAR CALL FOR INSPEC:TION <br /> POST� N 25!3-8811 <br /> EXPIRATIAN JOBSiTE 24HRS. EiEFOFIECONSI"RUCTIO�I <br /> I _. <br />