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""'"` APPLiCATION FOR PUBLIC WORKS P�RMIT <br />� TYGe or P�inl Cleatly with ink ^� / <br />PRESS HARD • YOU AHE MAKING COPIES pERMIT NO. '2 «� IC' <br />PUBLIC WORKS <br />EVERETT, WASHINGTON n p �� BLDG. DEPT. NO. <br />�OWNER ❑ AGENT DATE __"1- �V_ '_'_t._- <br />APPLICANT/FIRM REPRESENTED _L'Z�U.-1.>_I�I�--�L/�I ___ <br />ADDRESS I�71'-' � �i�-1�. CITY �nION �� T�L�PHONE ^3 �'��) <br />HEREBY APPUES FOR PERMISSION TO �f�S' e I� l� d* YQSi �C �ICP /1�' <br />ATTHEFOLLOWINGLOCATION I�iL�� �'u�l��»�� �J�p�t[� <br />Attach five (5) copies of preliminary plans for proposed work Draw to scale and show the following as applicable: <br />' Property lines and street identity. <br />• Outline and dimensions of existing and <br />proposed structures. <br />• Existing and proposed utilities. <br />• Centerline of abutting right of way. <br />' Topographic changes requiring cuta and fills <br />other than normal foundation. <br />' On-site drainage systems when required. <br />' Erosion control methods when required. <br />• North arrow � <br />coNoirioNs: PUBLIC WORKS PERMIT <br />�i. .. h1�'o�i� �„�- rEcv��,�7_e� -�-�ct•� -�Pv�<c� <br />_... 1 <br />.�.. �.1. '. u.� Cti,"5 �1 �/ ✓�� � Ci ... ��� �n� i 1 1 ( �. v+� o,� L <br />j... <br />� _. � <br />.. � (t'c�l1E'"::,�t'.�/ <br />i �! . -1-U� 'C^'� � <br />_t ._� <br />1,.� �1±�.;. �'.�I� �..� �" <br />v�. � 1 � (J �. . <br />�t�� 1�•-�-i1}- t�-I - ti !ii L� <br />�-}-, � � , �, r- t - ��I;.i _� .j <br />_ <br />� � � <br />� 1 a_�. � 4. _ ,.:_ � 1_.t-, � �� . � + I_.. <br />� <br />�, � � � ,� � � t, ,, .._ , � . f ! ! <br />.� ,..;._ ___, �,�._ �_,_... , :-..�. _ . _ . . _ . , . . <br />y111_ i�` .._ <br />l � r-�-- ' <br />� !'.: <br />; �_;...,_. <br />The un0ersipned owner �ereby eBrees to hold entl swa ��rmlass <br />the Clty ol Everett irom eny ena au clalme for 4m�qeti w�16 <br />expenses, or ceuses ol action thet mey ariee bauu�s W Imt�lUllon <br />and melnlanence ol Me improvemant or olher rlq�trol-w�y u�e <br />Ameb. Dnn11nA Inr anA IuAFe� e�.wwe m remove uma uoon notla <br />