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r <br />w APPLICATION FOR PUBLIC WORKS PERMIT <br />C <br />PUBLIC WORKS <br />ERETf WASHINGTON <br />TyDe or Orint clearly wi�� ink <br />PRESS HARD - YOU ARE MAKING COPIES �� y3 <br />PERMIT NO. _ <br />EV , �LDG. DEPT. NO._ <br />❑ OWNER ❑ AGENT DATE _ _3 � �' � t' 3 _ <br />A?PUCANT/FIRM REPRESENTED _����-✓' <br />/ // <br />ADDRESS �L�/%1 hl d/% G CIN I�L�lci T TELEPHONE L S�� <br />HEREBY APPUES FOF PERMISSION TO n 1raC � cIN �+^ p SiP i i,t__Q. F 'a CI f l <br />I i <br />_ cI r �J� �t - 7�,.. �J�r x� �„r....i— <br />AT THE FOLLOWING LOCATION �? �' �y �'�� ���'»'� r C <br />Attach five (5) copies of preliminary plans for proposed work. Draw to scale and show the following as applicable: <br />' Property lines arid street identity. <br />* Outline and dimensions of existing and <br />proposed structures. <br />• Existing and proposed utilities. <br />' Centerline of abutting right oi way. <br />CONDITIONS: <br />PUBLIC <br />' Topographic changes requiring cuts a^a fills <br />other than normal foundatian. <br />' On•site drainage systems when required. <br />• Erosion control methods when required. <br />. ni,..n�,�..,.,.. . .r <br />�., �t�w�05�Ier w�u�al- �e_ I<e(� 1 QS c"IOSe �� PQS��- S�cl<. <br />4�� 1 . <br />�� �e,.l us Pc,-�-.,ble <br />^ , �' �/ / <br />Z. �i�fP��'�,..i- ,�., ;P3�U„S�hl� :� �,� l,;y' ..,�/,u,C/(qRls 7'�RI� �«r� <br />IN• vx.Gt��� �� i�GfP's � bv!-"-�- r'�� ii ��f.� �-t�e�.7 e�Nw'4:. i�r'" <br />17 •� �9�1 r^�0..[P�X�. <br />3. ��I�(U�/.t1 �\�f G�Mv��Sic! jS �1.�..YrV �__�r/�i—C' J� <br />-��,.0 '�—:1U� ��3. v7�,�,,.s,�r,r is p��� ��„ 6�� ��� <br />�ti ��c1rt' ��1�t� ������v -l��a� 11 <br />c(urnK` <br />1 <br />'I���h��' �1�lha-� r't'rlccl� <br />� <br />l <br />_•.--- � <br />� "% � <br />/yy"/���✓ G. _ �'_�.�j' <br />,- APPROVEp FOR CO - DATE <br />_� j � 'G/Jt�� <br />/ A ROVED C UCTEG �L D Tf_ � <br />PERMIT IS VALID FOR 1 YEAR <br />EXPIRATION <br />POST ON <br />JOBSITE <br />c�c�1�(-t•�ti_t �vC' c�R�$ <br />Th d ad h b h Id d h I <br />e un ersign_ owner ere y agrees to o an seve erme�s <br />ihe Clly ol Everetl trom any ena an c�aimn lor EamaOen, coele, <br />evDenses, or causes ol ection Ihel mey eriee beuu.e of imt�lletlon <br />end maintenence oi Me imvrovemnnt or other tlqht-ol�w�y use <br />harelo eDO�ietl lof antl IunhBr Bplee6 to remova eeme upon notke <br />Irom Ihe Cily an0 to ra0late Dublic proPerty demaped t�ereby. <br />CALL FOR INSPECTION <br />259-8811 <br />24 HRS. BEFORE CONSTRUCTION <br />, <br />