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evereit APPLIC,4T . .JN FOR PUBLIC W�F►. .S PERMIT <br /> � TYVe or Punt cicatly wilh mk . . <br /> PRESS I1AFiD �YOU ARE MAKING COI'IES �`� � � ` <br /> PERMIT NO. .__ _ . . <br /> PUBLIC WORKS <br /> EVERETT,WASHINGTON � � - BLDG. DEPT. NO. ._. <br /> ❑ OWNER ❑ AGENT DATE <br /> APPLICANT/FIRM REPRESENTED _.f!'_� � � � . � �� � � " �� � - __. . - --- <br /> ADDRESS -<'—�---� �-'.---�------:• /1�1�t c /f�11�_ .'�ITY � !�( k.�c i'- -TELEPHONE �� � S �'��'��'-- <br /> . HEREBY APPLIES FOR PERMISSION TO ��5�%1f C = ___ _ '� /r'_ _� ___` '"( ' - %����'/ <br /> ATTHE FOLLOWING LOCATION __ �'� �_'�'_�_ �_��� � r. 'F�-.�-��?.� �I_' � - — — -- ,: I:,� <br /> Attach five(5)copies of preliminary plans(or proposed work.Dr�w to�cale and show the following as ap{�iicable: <br /> ` Property lines and street identity. ' Topograpliic changes requiring cuts and (ills <br /> ' Outline and dimensions of existing and other than normal foundati�n. <br /> proposed strucWres. ' On•si2e arainage system: when r�4�iired. <br /> • Existing and proposed utilities. " Erosion control methods wh�;n required. <br /> ' Centerline of abutting right of way. * Norih arYow <br /> _ ..--_ �_ ._ _ Siqnetmc ol AVI-hcdm _ . - <br /> PUB�tC WORKS PERMIT <br /> CONDITIONS: <br /> i . � - � <br /> � , � ��� . ,..�� n. 1�; .kF��i�. l.� ..�,�;�. a',,�.� -0 4 .. . <br /> ; �- �^!. (.r� \ �o . �� ' t..���.� t w •} ��.�.-. . 1�H� � !�;"- /� <br /> , ... .n.S: d b.� b„ �a� ,- _ , <br /> --, <br /> . �� �� --t-fc�c:��L � ' . �-' 1 ,._ ��, _,�, t , � <br /> � <br /> , ,.� -.�1.�� <• ,. , � <br /> I iic umiciciJneif c+ner IwreLy .�grees to M1o�J end save hvmlqss <br /> Ihi: City of Cvereti Irom any ancl atl claim5 lor tlamage:, cosis. <br /> c.nanses,or causes ol atlion Iha�may ariso hecause ol inNalls�iun <br /> ,in;l inninten.mce G Oie improvemonl oi e�ner ugh(�oV+vay use <br /> . livr,_lo a�.nb,�tl lor nnn ��uthrr �ig�r�•s lo n,mov�same upon nohcr <br /> Iron� Ihc G.!v „cJ t' ,pl.�co pu9hc �r:ne'11' da�m9�d Ihcrub'. <br /> — . . .., - r. � <br /> „_J�v :��'r�l.!'fL--'� � .��� ' . <br /> � APPROVED FOR GON.`iTFUCTION DATE �CKNr'iWU�D(o�N NT OF CONDITI!1NS <br /> i r ' <br /> i � \_' <br /> APPROVED: SCON:TRUCTED DATE SIGKATUREOFAPPUCANT UATE <br /> PERMIT IS ilALld FOR 1 YEAI� CAIL FOR INSPECTION <br /> POST UN 259-F38i 9 <br /> EXRIRATION —�--' �_ JOF3S17'E 2qHRS. D�FORE(;ONSTRUCTION <br />