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eV�1 APPLlCATION FOR PUBLIC WORIKS PE�II�IIT <br />TYP�' �r p, p cicailY wilh Ink / <br />PRESS HARfI � 1'O.� ARE'dAKING COPIES "�,��� i�L� U <br />PFRMIT NO. � <br />PUBLIC WORKS � <br />EV[�!ETT,WASHINGTON � N2/10285 <br />3;,:,,,..- BLD., DEPT. NO. . -- <br />fl OWNER f 1 HGENT DATE � � <br />11i111s I!�,r�.o-� 1nc. <br />�PPLIGANT/FIRM REPRESENTED � <br />.�- .� F�vr,rorC tfa: L Ftay Ever��.t�. <br />40DRESS � � � � ..—_ -. CITY _ _ <br />TELEPHONE _. �J-4492 <br />HEREBY APPLIES FOR PERtidSSION TO i�"tall dziveway <br />AT THE FOLLOWING LOCATION <br />t,��t �,� �,�,�� -�y+� ;► >�.t� <br />Altach five (5) copies ol preliminary plans for proposed work. Draw to scale and show the following as applicable: <br />' Property lines and street identity. ' Topograpnic changes requiring cuts and (ilis <br />' Outline and dimensions of existing and other than normal foundation. <br />proposed structures. ' Omsile drainage systems when required. <br />' F.xisling and proposed utilities. ' Erosion control methods when required. <br />' Centerline of abutling ri3ht ot way. ' Nojth Arrow / � <br />� � i <br />,,� <br />„� l%'�a . . : <br />.�iljllA�llll� ��1 (��1(lllfdll� <br />PUBLIC WQ�RKfi PERMiT <br />CONDITIONS: <br />.'% ,' / f��_.__ .i S' � `-. <br />APPROVED FO��STRUCTIOIj �� � ' DATE <br />,�,,�i � <br />� �/ _�� � (. �_t - �l� �� � ��� �� <br />f V <br />APPqO\�ED AS CONSTRUGTEO �" � AT - <br />�, � �,..,i, ,;,. ; ,,�,.i.����,•,�:,��,:���,��,.-� <br />� .. i . � � . , i. �.. , ..n ,in � �nmis Ini .Iernn(�e!'�. ce5is. <br />�..p�.nor.. � i i d�.ieus ol arbon �lµ:l niaV ����e WlcHuse ol inslallnbUn <br />end mainlonence o� Ihu impmvamont or ol�er np1Y.�obwny usr <br />h��relo epplmA lor and �wlher aB�aes l0 remow� seme upon nolirr <br />hom Pie C�ly nnA �o ropl9ce pUL�ic p�aP�'�i) AnmapcA Ihnmby <br />' ACKNO L GE NT F CONDITIONS <br />,����;-` � � <br />SIG URE OF A PLICANT Ul�TE <br />PERMIT IS VALID FOR 1 YEAR CALL fOR INSPECTION <br />PAST' ON <br />7- j j � JGBSITE 24 HRS. BEFl1RECONSTRUCTION <br />EXPIRATION--�-._.-----.__. _---- <br />