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_ � <br /> r <br /> 1 <br /> r <br /> - -- - 1 <br /> �ren pppLI�ATION FOR PUBLIC WORKS PERMiT — <br /> � TYOe or Grinl cleerly wil�Ink I <br /> PRESS f1ARD•YOU ARE MAKING COPIES NERMIT NO. �3 � <br /> PUBLIC WORKS � BLDG.DEPT. NO.��/—.—L—� <br /> j' EVERETf,WASHINGTON � ` �_v , � <br /> O OWNER �?�GENT DATE —� <br /> O <br /> AppNBANT/FIRM REPRESENTED _ /_� ��, �y-- ,J <br /> �oc�{y �t�,eSNI/1� ���57/li) c'�� ���''� <br /> ADDRESS ����� � /� <br /> CFi I�Y �D � � CITY GJL��TELEPHONE_���'�U / <br /> HEREBY APPLIES FOR PERMISSION TO — <br /> c c L �h r u .'` C:`�i �it'C�G <br /> ��� E 'i �.=� <br /> AT THE FOLLOWING LOCATION <br /> Attach five(5)copies oi preliminary plans lor proposed work Draw to scale and show the following as applicable: <br /> ' PropertY lines and street identity. • Topographic changes requiring cuts and fills <br /> ` Outline a�d dimensions of exisling and other than normal foundation. <br /> proposed structures. • On-site drainage systems when required. <br /> ` Existing and proposed utilities. ' Erosion control methods when required. <br /> •Cente iine of abutting right of way. ' North a fow <br /> �t�- � <br /> slane m ot Aoa icant <br /> PUBLIC WORKS PER IT <br /> CONDITIONS; <br /> I . . . <br /> , . . . . �. Driveway must be level with edge of existing roadway at praperty me. <br /> ' - ' ' ' ' ' 2. That portion of ttie driveway extending into the rigfit of way must be paved. <br /> i . . . , <br /> � � 9. Private pressure sewcr syste-ns require a manhole to be installed at or near <br /> �'�'-` ' ' ' properfy line to bieak pressure and gravity feed from property line into Sewer ' <br /> ! . . lateral in right of way. <br /> ' ' ' ' ' � 4.. £rosion control may be [equired at the discretion of the Public Works inspector <br /> at the lower end of the property, if erosion begins ta wash into creek area. <br /> _ : : : :��, � c�� �.Q DI��� ��'� ���Q. <br /> _ - . . . : . . : (�Sc ILd;uti��a.•�` rz�z�j <br /> � � . . . , . ; . , . � . . � <br /> , . , .__�r.---� • •-• -"'-' ' ' " ' ' ' � � � � Tne unders�ipnetl owner hereUy agiees to�oIE antl eeve�ermlens <br /> � � � - ' ' � � t�e Ciry ol Everett imm any ena nu clelms �or Aamape4 coata, <br /> i - ' � ' aRpenses,or teuses ol OCtion 1�01 may arine betause of InslUleUon <br /> � � � � ' ' ' � and meinlanance of ihe impmvemenl or ot�er rlant�o4wey use <br /> � � � � ' ' ' � ' � � Ooreto appiied lar antl lunher egmes lo remove seme�pon notice <br /> ' - ' ' ' ' - ' � . . Irom ina Cily enC to rev�eca vuouc ompae� dameped ��ereby. <br /> �/ / /�/�i " ACKNqW DGEMENT OF ONDITIO S <br /> L VED FO CO N . DATE . J <br /> G-�)/h- . 7/[_��C� L <br /> _� DATE IG E OF P I ANT DATE <br /> CALL FOR INSPECTION <br /> PERMIIT IS VALID FOR 1 YEAR pOST ON 259-8811 <br /> JOBSITE 24 HRS.BEFORE CONSTRUCTION � <br /> EXPIRATION <br /> � J <br />