505 VERALENE WAY SW 2016-01-01 MF Import

e"e`e" � APPLI�ATIOf� FOR PUBLIC WORKS PERMIT � TYPr or Prinl cleadY with ink PRESS HARD-YOU ARE MAKING COPIES pERMIT NO. x Z/�_."�_ .___— PUBLIC WORKS //^ EVERETT,WASHINGTON L_ � . �� BLDG. DEPT. Np.�Y��^t �� ❑ OWNER ❑ AGENT DATE _ APPLICANT/FIRM RFPRESENTED �.� � � S ��N �� __ _ .. _ . __ _ ._ ADDRESS ��L�_=' �' �� l� �c'�_77 i1NA�L U� ��_ CITY ��r i1 TELEPHONE J SS�-�J��'!-= HEREBY APPLIES FOR PERMISSION TO C�S��« �"t �<<^��`"r 7t �r��i✓c=«i1�/ --------- ---- - - - --- --- - -- or- S�, - _ 5 a j (Lpra/pH e l.vay s�,,J -. - — L:<�1,•r��:x- C-a,,,-,� S AT THE FOLLOWING LOCATION _ - Attach five(5)copies of preliminary plans for proposed work.Draw to scale and show the following as applicable: ` Property lines and street identity. " Topographic changes requiring cuts and fills ' Outtine and dimensions of existing and other tY:an normal foundation. proposed siructures. ' On-site drainage syslems when requ'red. ' Existing and proposed utilities. /" Ero ion control methods when required. ' Canterline of abutting right of way. / ^ Nort arrow j 1 __/��,''r'�' '��C l�. ----- - — L �rtjnatur,�ol APPhc�nl PUB�iL 'v�°ORKS P�RILIIT CONDITIONS: '��_�:� f - ��:� _n �:: � , . c ,,,,.3� �., . _.. . ' �,., i, . %� ! iv , ine undersiyne[1 ownei I�cmbv agrees lo '.oltl nntl save harmless Ihu City ol Everetl irom eny ana all claims fer tlamages, co5ts, e.penses,or causes ol ar�ion t�at may ariso beeeuse ol installabon and maintenance ot Ihu Impwvement c.r other righ4o4way use hereto ap0�ied lor and I¢�her agrees lo remove scme upon nobtt � Irom Ihe Clty and to repince public property Aan�aged Iherpby. �,a,i ;; :,,�:�:_--_a'_ 5/ J'� ,__ _._ / ,I�PPROVED FOR CONSTRUCTION DATE � A0.�'J WLBGGE F�IJT OF ONUITIUNS AF�'�'' / �, °2_(/,/1g q-- �-/%-�� ,"�, (,�',1/.�9 � /'fi' �L_ ---- -- (�?VE�ASCON TRUGTED Y 6ATE SI, ATUFEOFAPPLICANT � pATE f�ERMIT IS VALID FOR 1 YEAR pOST ON CALL FOR IN�PECTION 259•8891 EXPIRATION - � `4 ' _ JOBSIYE 74 HRS. BEFt'�RE�ONSTRUCTION