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everett AP�i.I�ATION! FOR I�U�LIC WORKS PERNlIT <br />� TYae or Print clearlv wilh inl< -. � <br />PRESS HARD - Y'OU ARE MAKING COPIEu pERMIT NO. /��- <br />PUBLIC WORKS <br />EVERETT, WASHINGTON �f Z p J�Z BLDG. DC-PT. NO. <br />�I OWNER ❑ AGENT DATE � � <br />APPLICANT/FIRM REPRESENTED _,LY1L(�IL� �i✓if _ —. <br />ADDRESS _p—�� ���C2ETT /YJ79LL L(/A-7 cirv Ev�=��G'T TELEPHONE -3SS'��F%,� <br />HEREBY APPLIES FOR PERMISSION TO ��S T��� �"S� W�,�� C�iVC/c'��� g%N[:-W� <br />ATTHE FOLLOWING LOCATION <br />Lof 1 � l��?ilu Q� L`S�iu�.i •� :l L'� � I I, 1)� W4 <br />Attach five (5) copies of preliminary plans for proposed work. Draw to scale and show the folluwing 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 />�� <br />* Topographic changes requiring cuts and iills <br />other than normal foundation. <br />" On-site drainage systems when required. <br />* Erosion control mgthods when required. <br />f AMTflw�rrrnu � �^� <br />RM <br />CONDITIONS: <br />� r <br />{ �� ` „ �I � �1 <br />, . . . . Ic �'JfeC'.n �4�e�� . c-Ct� � mP•.,�T � C..recL is, ho� �o ��� CI�Pu�Nd- . <br />... .�, .�co�.- �(�. c.�rn�rcrS�. mvuF L�i., ctt•..�{r�li��:a.. i-�,�� Io�F. <br />� <br />� -3 •�.��,� a�xr.nus�._c�i. �'r��<rfC_�.IwE1.� �O.aU, o.ccc:�,-�., <br />v � . � <br />. . �• . clwe . •ia, ro ,: fra« �ie.� .muaf br. ���xi,�r�� Ly .6 ,.�c r'i. ; <br />•-�e( �L '�� �u_ �,6/,i i2q.[.y. f.r,..- -!/.i' cn,.s�-ru:ofie;y' <br />.a� _ ./.�aa.0 �. . . . . . <br />. . . ; . • . . � �:yC� /J ��. . Ji'. _ (�/Bnfc.�ti-�. f/Lti/y . . . . . . . . <br />� <br />i. ._ ._... _- f. .'%i�F ...C'l�iJ �ir,___�o .. -<ri� �. .. ./r,v � DLfiP � �SO�..�l i'qSar�i�. _.G'C�.-•"f'i-_ . _ . <br />✓ <br />j. ... i <br />� . . . . . : ��. ��/.�,P . ���. . nsN;s f d/r7 --F,�//�� i..�� /'�'f/a��h�� -,�u .� n.:� . <br />---'._ _. �.'.Ol,. .`C . ...�v -i? � �.lS�r/�f'✓, il..�(� ��/i�t/.:Cl( 7�_ 7—r�G S'�G..—c.a <br />�`�. . . . . . , U . . <br />I / <br />� -. . . ,C//E+��.�. 5-,j;Gr.av, . . . . � <br />i . <br />•_' _ ' . . <br />�`�'�1 �� ��- � The undersigned ownr.r hr.re6y agrees lo holC antl save harmless <br />������ � �� Ine City of Everelt irom any ana all ciaims for dama8es, cos�s, <br />� � � � , � . , , , . . , . . . . . expenses, or causes of action Ihat may arise bece�se of Installation <br />. . . . . . . . . . . . . . . . . . . . . . . . . . . antl maintenance of Ihe improvement or olher �ipM�ol-way use <br />. . . . . . . . . . . . . . . . . . . . . . . hereto applied lor and luriher agrees to remove samo upon notice <br />� � Irom the City and lo replace public propatly damaged ihereby. <br />�r���>-- 73�—�2 <br />..��on�i�n cno rnnicrot iCT;hN mATF PCK�LEDGEMENT OF CONDITIONS <br />PFRAlIIT I � VAL <br />_XPIRATION <br />l <br />—� �'L <br />FOR 1 YEAR pQST ON I CALL FOR INSNEG'tl��d <br />259-8811 <br />JOBSIT[ ! 24 HRS. BEFORE COtVS'TF+i)�CYION <br />