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--. <br />e�j APPLi�aTlON FOR PUIBL,IC WORKS PERMIT <br />I Type or prinl ciearty with ir�k <br />� PRESS Hi�F;D - YOU ARE h1AKING COPIES pERM1T NO. `��/a" n� <br />PUBLIC WORKS <br />EVERETT, WASHINGTON �_/v ^�� gl_DG. DEPT. NO. <br />�OWNER ❑ AGENT DATF . _ .._______ . _ __ <br />�[�/ �• <br />APPLICANT/FIRM REPRESENTED j/_LL L !S _ _ _ f,�C� .�LN�—__ _____._. _—_—_----_. <br />ADDRESSOv�_c.���� CyFI2E-�%���L L�x_CITY �v�2r�TELEPHONE 3�.� 7�/L <br />HEREBY APPLIfS FOR PEFMISSION TO LNS%�� OZS� GI'/J� '�/(�C(C�'T� C��ll�w�{ l/ <br />— Y— <br />AT THE FOLLOWING LOCATION �S'�� �- <br />��1i� <br />—1.� O� � � �-�, ��. <br />Attach five (5) copies of preliminary plans for proposed work. Draw to scale and show the following as appiicable: <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 />CONDITIONS: PUBLIC �iVOR <br />-�/ , { <br />/ (�/"Pf�•� — �'/f / CL25:'o.:P-..i� afPo_ <br />1 <br />a. � i��-� -I:o �r cl r�„ � �: S� wi ti; t- b z <br />J <br />� <br />il R w1u �ti G.� Y.�Ctc..�.c F�C '� <br />C�c:v,•:-•{r�.ic'�,o.� «�..•si- be. <br />�r��� �S �—%a c}cr_.� <br />.�.��E-' IS �fo ��' <br />i., �-� ��, 6C._ <br />CI 2ct ,� .•.S1 , <br />..�ie `r'J!.��'� ��C-'f'"J�tlt bCYi <br />��rac1E P�".cr ��v <br />1 <br />i� � <br />/ <br />-1-,,.::�� <br />iI <br />��_/ / . ll � J'� � .-I' =- <br />�1C PROVED FOR CONSTRUCTION DAT� <br />(�c, ���o....,�� rl��14,3 <br />PEFiMIT 15 VaLID FOR 1 YEAR <br />EXPIRATIOP. <br />' Topographic changes requiring cuts and fills <br />other than normai foundation. <br />' On-site drainage systems when required. <br />* Erosion control rr�thods when required. <br />PERM <br />t 5 nc � '�'o Y� r C � f:-: / c'c� � <br />C�•in.�fr IIe,.1�� G�. 'Y�L ���'r <br />,��.%�i�, h.17.�1+N <br />re �G.: . ->l� <br />�. U .VJ . '�.'J .— <br />„�� CIG•.I.� <br />I . , <br />I�> � _ �� �I,� ., . k-4V <br />-i,'9 � CiJ �' •. : 1 . <br />POST ON <br />JOBSITE <br />, GCG.n�r�n ���('- <br />i,� b.,,l�l� <br />r�11C !?lll?r/YfC'�ICv� <br />-1� -�,..�,� I . �- <br />The undersignetl owncr heraby aq�ees to hold antl save �armlass <br />the G�ry of Everntl trom any ano an clalms lor damege:,, costs, <br />ezpenses, or causes ol aclion Ihal may arise becAuse of instaDa;ion <br />and mainlenance al t�e improvement or olhor righ4of-way use <br />herelo applied lor and f�ir�her ag�ees to �emove same upon nolice <br />Irom the City and to reolace Oublic pmporty demaged thereby. <br />EMENT�bF CfJNDITIONS <br />CALL FJR INSPECTION <br />259-8811 <br />24 H RS. BEFORE CONSTRUCTIOIV <br />