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421 VERALENE WAY SW 2016-01-01 MF Import
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421 VERALENE WAY SW 2016-01-01 MF Import
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Last modified
3/8/2017 9:19:12 AM
Creation date
3/8/2017 9:19:07 AM
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Template:
Address Document
Street Name
VERALENE WAY SW
Street Number
421
Imported From Microfiche
Yes
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i <br /> i <br /> eV� A�P�ICA'�IQIN �OR P�1BlLI�C; �YORKS PERMIT � <br /> Type or print Ueary�wil�ink � . / <br /> PRESS HARD-YOU ARE 6fAKING COPIES .�y� � I S�� <br /> PU3UC WORKS PERMIT NO. — / <br /> EVERETT,WASHINGTON BLDG. DEPT. NO..�J �L7O - <br /> � �OWNER ❑ AGENT DATE 9""�T�'�'�. __ <br /> APPLICANT/FIRM REPRESENTED ]�/LLI,s 1�Ch;�ES 1�G <br /> ADDRESS�� 5� ���I�E���_/7�At�-_��_CITY��G�_F'_T._—TELEPHC`'^.s3s5-y�Iy2 <br /> HEREBY APPLIES FOR PERMISSION TO .�N���L p�S�_��(v� CQN<�Pwt� �/vELUA�/ _ <br /> —� <br /> ATTHE FOLLOWING LOCATION �E� �_V-U�*C�<�[ LS�`z-7'�S _'_�yd�_�C�/�cG/He !�/A' .�Gffr <br /> Atlach five(5)cupies of preliminary pians tor proposed work. Draw to scale and show lhe following as applicable: <br /> ; ' Property lines and street identity. ' Topographic changes requiring cuts and fills <br /> ' Outline and dimensicns of existing and other than normal foundation. <br /> proposed structures. • On-site drainage systems when required. <br /> • Existing and pmposed utilities, ' n control ethods when �equired. <br /> ' Centerline oi abutting right of way. f " North arr w i / <br /> \ ---(_ � <br /> Si nalure ol ApO��cant <br /> CONDITIONS: PUBLIC WOI� S PcRM T <br /> ,. / <br /> /, rre� ' <br /> �j - .�.3Clf'� eQSPr'+tPr.y'Gtr:0. �S /�c* � �P CQrP <br /> �. ltlny �+9N+R`C �yi' �iCCY/'a34 � �i.v��� /2/i,�, bGcv r�� � 1 r/IiG �U <br /> / / //� j(� <br /> uon5�-/'ue�iu- .� �rr�c,� � ba /'e'���ircX � Iic,� ` P/ . <br /> 3, ��6�6 f,a����,, ,�0 Pti ��� .%�ti �,,.��,� «,,.r�.: � „�. <br /> /s ,6 6r c/tn� ��^ c{.s. y <br /> Y �p*• 7<l�J �4ih4� t /1 j`�/ GE' �O,;v7'O�/rcl/� <br /> O� `d�P /t7 ,/ � �c �� QYY! ih Gtr � /r n o � �j <br /> / V <br /> �/7I/il d�1 t� �tc//ctC�P��7�- .�b J`�Z <br /> -/ _ V / �/ <br /> �j �lCSf' lNa�✓ ,$'Pr✓ic�u �/IcrlNe !�K �O '� <br /> / n �*./ <br /> /�t / �/"`I'U�' i <br /> r <br /> The uneersignnA owner nereUy agrees lo holtl antl save harmless <br /> ihe Ciry ol Everett irom any ana au ciaims for dameyes, coets. <br /> mpenses,or causes ol aclion 7ha!may nrise beceuse ol inslellalion <br /> en0 mamtanance ol Ine impmvement or olhor ri0���ol�way use <br /> herelo appliod �or antl lu�ther agrees to reno�:e seme upon nolice <br /> �rom �he City and �o replece public proCerty demegod �horoby. <br /> APPROVED FOR CONSTRUCT�ON DATE ACKN Vd�CGE T/,pF CONDITIONS _ <br /> "" I�,14' 1 C� l�, t,^-�. � !� �j _ !/ W�� '1 lr�-- _-- <br /> AFTPROVED AS CONS �UCTED DATE SI RE F PLICANT DATE <br /> PERMIT IS VALID FOR 1 YEAR , CALL FOR INSPECTIOJN <br /> POST qb! 259-8811 <br /> FXPIRATION JOBSITE 24HRS. B�FORECONSTRU(:TION <br /> � — i <br />
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