Laserfiche WebLink
eve� ppp��GqTIQN �QR PUBLIC WORKS PERMIT <br /> GPype or Orinl cleatly with ink <br /> � PRESS HARD-YOU ARE MAKING COPIFS pFaM1T NO. �°Z-3�' � <br /> PU6LIC WORKS <br /> EVERETT,WASHINGTON dLDG. DEPT. NO.t�a �O,_ <br /> ��O�,NN[R ❑ AGENT DATE �� - 3 ^�� - <br /> /[i(S ��rNCS ./-rflC, - - - -- - <br /> APPUCANT/FIRM REPRESENTED . - - - -- - � -- ���> <br /> ADDRESS ��- S'C• CU(<�i���R«- ..G�q".�___CITY CdEPE7�TELFPHONE 3SS y7=L-_ <br /> HEREBY APPLIES FOF PERMISSION TO J�S!��"�- ��S� C�l/lDE C��NC,eC:-T� �iPtl.t�t�'�`� <br /> z <br /> 0 <br /> -__'_-._'___-_—.__-_ _-_._._ ^ E- �IG��Ir �/�'�s � 5 /� P�R/C�r1_ W U�W m <br /> AT THE FOLLOWING LOCATION L�T�6 /�_k' __ ---� .. <br /> Attach tive(5)copies of preiiminary plans for proposed work.Draw to scale and show the foilowing as applicable: � T <br /> • Property lines and street identity. ' Topoyraphic changes req•�iring cuts and fills -. -� <br /> ` Outline and dimensions o( existing and other than normal foundation. N m <br /> proposed structures. * On-site drainage systems when required. �c o <br /> ` Existing and proposed utilities. ' Erosion control methods when required. �� <br /> ` Centerline of abutting right of way. ' Nort arr w � � � m <br /> {J / Tz <br /> - (T - --- � <br /> m` <br /> Si aWre ol ApPhcant � � <br /> CONDITIONS: PUBLIG W��.�� PE�� T �_ <br /> �N <br /> -G <br /> T <br /> ` O .� <br /> �i ��J� �l' C1ZGLfP . 'n � <br /> I� �J('C'f'rl ' ��'�' NCC$l' 1v1 P•�� G�f P 0. 1 S .� `�'� —1 fTt <br /> ( ' 1 S <br /> (' -t��`P�� U.. t�+�' �o�� m (n <br /> Z, �Oot• -�P dfn,wust N�NsE �C l:o•� ' o <br /> o r <br /> "7 J c�u� '� c tmi� <br /> 3. �a� [tc�muS< ar �re�� a�� � lwblw K.i� w. c�•c•����^ <br /> � <br /> m' <br /> N,1 e z n <br /> cvhS�H.;:�ru.-. �.,..�4 be �e�c�.r b.� lo d r. --ir <br /> m <br /> / f 1 z <br /> 7 �Of�1 �f6GI�PS' 1.�'� ������ Rr�.IN. 1'ro.... '�I��t CA.�sMHCY�o.i � <br /> _ <br /> -.,:a�. ,� �1. tic_ 01.�..�9 ,,.p �ld:l.�� z <br /> � <br /> � <br /> SA�I�u�i� w�.�v� -s��,.i.e v::lvc 10•�,. � .�,.+..I Iw�- .�ra� � N <br /> 0 <br /> -a <br /> n <br /> m <br /> Toc unAers:�ned owna hr�cby �9rees to hold antl Save ha'm �5 <br /> thu C��v ul 6�ure11 trom any ana au ciaims lor da��nages, . <br /> e.pensea,or causes ol action Ihol m[y arise 6etause ol insl ' <br /> and mainlanance o! Ne imDmvement or olher rightal�v <br /> �ereto aDPliod lor and turther ag�ees to remove same upo -- <br /> ;/ , <br /> Irom the City and to reDlace OW�ic p�oPetly dameBeO '•hY. <br /> "��i—'./1r��� ACKN L�G[M f OF�CONDITIONS � / <br /> R VED�F CUNSTRUCTION DATE ( � <br /> //�� �' x �-y,>S `� _��z_ �w_��- _ �,������y� <br /> 4_—�� = - --�� - --�- SIG ATUREOI�AP ICANT ATE� <br /> APPROVED AS C S RUCT DATE <br /> PERMIT t5 VALiD FOR 1 YEAR CALL Ff_1R INSPECTION <br /> POS'� , N 259-8811 <br /> JOBSITE 24HRS. BEFORECONSTRUCTION <br /> EXPIRATION <br /> ;;. <br />