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L <br />"'�`�" APPLICATION FOR PUSLIC WORKS PERMI� <br />� Type or vdnt c1eMy wlin Ink � <br />PRESS HARD • YOU ARE MAKING COPIES pERM1T NO. � <br />PUBLIC WORKS t/ <br />EVERETf. WASHINGTON /�, �,, _ BLL'G. DEPT. NO. .3 � 7 7 <br />❑ OWNER ❑ AGENT DATE � <br />APPLICANT/FIRM REPRESENTED <br />ADDRESS 373� �C� <br />_t=�T�TELEPHONE i�%S�/%l <br />/ � <br />HEREBY APPLIES FOR PERMISSION 70 6wU_ ���� — - <br />ATTHEFOLLOWINGLOCATION ,���� ��N✓N ��M <br />Attech five (5) copies of preliminary plans for proposed work Draw to scale and show the following as appflcable: <br />" Property lines and street identity. <br />• Outline and dimensions of existing and <br />proposed structures. <br />' Exiating an!1 proposed utflities. <br />• Centerline ot abutting right of way. <br />' Topographic changes requiring cuts and filla <br />other than normal foundation. <br />' On-site drainage systems when required. <br />• Erosion control methods when required. <br />• North arrpa'v__ . <br />CONDITIONS: . <br />; .. .:. 1 ' ` j <br />� . . . �1� . S�rM dfA�n. .p��('_. . GUhntcTo�.�/� Ir �A.��An� .}o. bc. 'yvI�a�ciG. . . . . <br />I. . . , . . . . , . .w��. 1+•C. CG��0.f 51'oi-.�ie�/ i� nPw�� �NS�n��pi.Y3,� . . . <br />;.... <br />i._ ........................,.f. . . ... . .. . .... ... ........, <br />. . Z��art. Por�ion ot 'IT'�^�C dr/�v�wa w�Tw�r� //"/�t�� �i.b��� �.0.(.v.. . <br />Er.-....... ..O\...SONN�..�!Y`. .S�Iq/I �i�.�i'iU`C�C� .. . ........ <br />I.. . . . . . . . . . . . . . . . . . . . . . . . . . . <br />_��. . ..-`-+-�.� . . . . . . . . . .. . .. .. . .. . .. ... . . . . . . . . . . . . . . _ _ i �.-ti._..-«r_i_�.._. . . <br />. . . � � � I • ��. � � , 1 ..1 • . . . . . � . . � . . , . . . . . � . . . <br />_ . . . ..�.�� � •f�� . . � • � � � T• �... I .. . . ._. . . . . . . . . . . . . . . . . . . . <br />� � , <br />I.' . . . . . � . . . � . . . I . . � % . � . ' . . . � � <br />�-� ���'+-�� � -��~-���JJ � The undersigneA owner hereby agrees lo ho10 ana eave hermle�a <br />t. . . . . . . . . . . . � . . . � . . . . . <br />� , , , ,.,. . the City ol Everelt Irom eny ena eu clelmn lor demepe0. �N�, <br />� � , , , , . ; . . . . . . . aMpenaes, or ceusee oi ectlon thet mey �dne becauee W le�t�l4lbn <br />' . . . . . . . . . . . . . . . . . . . . . . . . . . . � end meintenenca of ihe Improvement or olher dqM-oFway u�a <br />. .. ___.._�,____....�._'_"'_"_"_'..�.��.�.......,....x.. <br />