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r <br />r <br />� <br />�. <br />� <br />L <br />everett pppLlC�1TION �'OR P'UBi.IC WORKS PEFiIWPi' <br />� TYDe or Prinl claetly with ink ,� <br />PRE55 HARD - YOU ARE MAKING COPIES pERMiT NO. —�� -- <br />PUBLIC WORKS <br />EVERETT, WASHIN3TON BLDG. DEPT. NO.—. <br />. i _ >'_`o-'.� <br />�7.OWNER ❑ ACENT DATE -_ - � <br />APPI_ICANT/FIRM REPRESENTED << < � � �`�Y' `"�' L'S_�'t-��__ _— <br />i� <br />��;'. r( �V�%iZ�:�( /YJ/ItC G(%AI CITY F ��E�,C�El� TELEPHONE� ;S-��"-�/S�i�, <br />ADDRESS �� � '-�' - - -- _ <br />r � 1�ZrVE u/fi'` <br />HEREBY APPLIES FOR PERMISS�ON TO <br />/�J�� fJrL '>'� l�l�iJ� �Cn,��i�'c�'7 / <br />-- (t_ /� ��E_/'/4r(n,�t / `5i�l.z �-7310 �T—" ��. W <br />ATTHE FOLLOWING LOCAT�ON <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 iclentity. <br />` Outline and dimensions of existing and <br />proposed struct��res. <br />• Existing and proposed utiliries. <br />` Centerline of abulting right of way. <br />' Topographic changes reyuiring cuts and fills <br />other than normal fouridation. <br />• On-site drainage systems when required. <br />' Crosion control methods when required. <br />�'�lor(P aryow % <br />�f� 1�-�� -- <br />c- )- <br />ERM <br />CONDITIONS; <br />''. � : : . . � �, �. � I. I�.,o��� �-Foi�. dr..;�.�a�c ..,H:.E l.c �n..�z�.i',.�.,o , ..t.t to�. <br />� Z. .!Zd��.y.'{ o�se.1G/ .'.fJ�« �:..IcC bo., }e �..n.� Ic-i- �r. c�L <br />..... ^ , �,� �-�«.�..J <br />'_'",_„ " . 3:�(�tzec.,. i���t� Ea:c..-.o..i �. .,o �� <br />.�...,...... <br />. <br />. . <br />.. .,. <br />� i , <br />: . ,_. . . . .. __ • -- <br />- - - ' _ ��_ _ �� -.__ . - - - - - _ _ - <br />. . __ _ __.. <br />., , � ..:.....:.. ... <br />� .: ...,. <br />t ' j • <br />I .. � <br />. ..I. . <br />, <br />.,. I <br />i.�_., �. _.__-�— --� _ � _ T-- _ . <br />. : : ' � . . i . � . . , . . . . ' . <br />'j�:......�...;._., <br />' - _-, � --�----_•--�—'. `_'..._ `-`�"�... . - - � � Tnu unacrsi9ned owner hereby agrees lo hold and savo harmless <br />• -• • �''' '�' the City ol Everetl trom any ana an ciaims br damages, costs, <br />� � � ' • � � + ' ' � � � � � � � � exoenses, or causes of aclion tha� may arise because ot Installation <br />�''''-"' ' � and mainlenance ol Ihe improvemont or othor riBhPof-way use <br />'''''-'�' here�o ap0�ied br and luriher a9rees lo remove same upon notice <br />'' '�� �J ircm Iha City end to roPlacu public pmpetly damaged �hereby. <br />. . . . '. . � i// / ._ / . % ; �� <br />APPROVED AS GONJi <br />PERMIT IS VA <br />EXPI RA?ION <br />i. > J` � , <br />)N AT/E E <br />� _ ii�9 / �i�,� � <br />OF CONUITIONS <br />7 � "__ �-� �'�r'�' <br />1 <br />F7R 1'Y A� R CALL Ft7R INSPECTI�iiN <br />POSTi OPI 259-8811 <br />JOBSITE 24HRS.BEFORECONSTRUCTIQN <br />� <br />`� <br />� <br />� <br />tl <br />.� <br />