Laserfiche WebLink
\i <br /> __.'� <br /> "'�'�" APPLiCATION FOR PUBLIC WORKS PERMIT <br /> � TYPe or Pdnl cle�tlY vAt�Ink [i <br /> PRE55 HAfiD-YOU AF;E MAKING C9FlES� pERM1T NO. a �/37�' <br /> PUBLIC WORKS <br /> �E ERETT,VJASHINGTON BLDG. DEPT. NO. <br /> OWNER Cf AGENT DATE _�� _!�!!!��� r _ <br /> APPLICANJ,(FIRM REPRESENTED -_���� � �� --- <br /> ADORESS�i � � `� CITY ��Q��TTELEPHONE � ` ��� <br /> HEREBY APPLIES FOR PERMISSION TO _1L��'��� 4 `-"���J� ��� <br /> � � '�' ING��.c�'�,.� �ra �.,a �c. c.� ..�o, � � �a.. <br /> ATTHEFOLLOWINGLOCATIO ���J��' � " R"� �� <br /> Attach five(5)copies of preliminary plans for proposed work.Draw to�cale and show the following as appliceble: <br /> � Property lines and street identity. • Topographic changes requiring cuts and filla <br /> ' Outifne and dimensions of existing and other than normal foundation. <br /> proposed structures. ' On-site drainage systems when required. <br /> ' Exfating and proposed utiUtfes. • Erosion control methods when required. <br /> "Centerline of abutting right of way. ' North arrow <br /> SIQn�ture ol AD017unt <br /> coNomoNs: PUBUC WORKS PERMIT <br /> _ _ _ _. � <br /> ; <br /> � L1 , � �N$�!'\ �Ul' f-f-f Ci.�..� ��Q �.h��f t N-'� �' ��.r . � � ' �l <br /> � ; �♦�.{._. . . eIN�1 �(tte!�CJ�� LCG �hN Sor� �OONJr.Y�b` � � � ...i <br /> 4 � ' ; <br /> ( a � r� �I <br /> f( ��.�_, f U�-. F�.rfl•+{ z f 171 `. , . . . }� .. <br /> i�- � � f i <br /> � <br /> ' � I L� .. . u�Q.I�I�NGJ� YIQ✓� �Ol.�.r ,y� l S\ \ � �JN.� 1VUl� SC�^!.Ci� . . E �. ._I <br /> I <br /> •�. �r `_• ia ' � ���� <br /> �� 1 gL, . `� I <br /> j ��T l" . `l �'..t�e-! �c'�,i �c � p��...s �fsa�.� cJc .e..._Y� , ci.ro..;... `.. . , <br /> V � � � <br /> � �"f",_. � � 'S�a tt.,.�� c' c . .i <br /> 1� i l ' o, s �s i-r��.,_a �Ql �n�i� � �s <br /> } � ��.. , . . _ . ' i <br /> � ��1 ' � ' �� �`�� �� Q�,� �.�s . � � � � <br /> . <br /> ; , � �__, _ � � � <br /> ;� , _i_ _ � , � <br /> � �. 1 �� - _ _ ._ . _. _ <br /> � • <br /> I -T �� i i � I _�i�� I i .�_! I ' � L -.1 .� � Tne uneeraipnee owner nereey eQreas to ndE�nE ura Mrm�au <br /> . I i � � ' 1 . , . ' .-�- �. t--.-� . Ihe CItY ol Evercu mm �nY �na �n oie�me lor d�mq�s, cutt, <br /> � I ,� ,_, ,_ � � , _.-+-1.-� � --.+--. - � � eapenaea,or ceua-• • �ction ihet may�tlu beuuw d In�t�ll�fbn <br /> i <br /> t......._ . .. .. . � . 1 � . . . .--, . � �� enA msintenenc< .,t �M ImDrovement o: MMr rlphlrolwr�Y u�� <br /> i .. . �. � . �.. . .. ..- .. �:.. �arero ep d � en4 wrthar�Oroe�to ramors wm�upon irotla <br /> hom 1� Cit eat b repl�ce publk propeM d�m�qW M�r!'•y. <br /> /�` ��� �� �7 �Z� <br /> `A' PPROVED F R CONSTR�ION ATE A EDGE T OF CONDIIIONS <br /> � / `_ V <br /> � <br /> / -//-� \ <br /> ASCON 1CTE0 DATE SI A UREO P IC DATE <br /> PERMIT IS VALID FOR 1 YEAR ppST ON CA�� FOR INSPECTION <br /> 259•8811 <br /> EXPIRATION JOBSIT� 24HRS. BEFORECONSTRUCTION <br /> � _1 <br />