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� <br />j <br />� <br />everett pppLICATi�N FO�R PUBLIC WOF%KS PERMIT� <br />� TYVe oi �rmt c.learly wilh ink <br />PR�SS HARD - YOU ARE MAKING COPIES �� 3 �� <br />PUBLIC WORKS PERMIT NO. _ _ __ ____. <br />EVERETI'. WASHINGTON 3� /f3F> <br />BL'JG. DEPT. NO. � � <br />�3-..OWNER [7 ,4GENT DATE I " ��,� �i�� <br />APPLICANT/FIRMREPRESENTEO T'�LC�S ,�`1P/'1i�-S-//�c' <br />ADDRESS .��L' .S. ( , C L�� l�'�:77 �)��r[ [l���/ .. _ CITY � r �� �'E r/ TELEPNONE��S�L_Ylc�--- <br />HEREBY APPUES FOR PERMISSIO.': TU ��✓�//[c__ o'� �/C�'dY �C�N���-�� � a^�� ✓< <�'�%% _ <br />AT THE FOLLUWING LOCATION �� � //n ( � �t,.� _ ,vE �"$Tfitt_S — j��� %Sr� /�� S,W ' <br />Attach five (5) copies of preliminary plans for proposed v.�ork. Draw te scale and show the followinq as applicable: <br />• Property !ines and streel identity. • Topographic changes requiring cuts and fills <br />' Outlirie and dimensions of existing and other than normal foundation. <br />proposed structures. • On-site drainage systems when required. <br />' Existinp and proposed utilities. • ErosiDn control me fiods when required. <br />' CeMerline of abutting right of way. /' North�w � / <br />� �i i� ��_ <br />.- .-..tSlpn�raolAPP6canl <br />coN�irioNs: PUBLIC WORKS PERMIT <br />b(�l��.� -L3Pi/�� CRS��.�., f st�ln �t ncf {�, 4ie r�trri�.�!� <br />/lK,I - �,��J dYi�i��s.� e .n�.5f 6P Grin �ro/�i von �i:e �o�. <br />�� �Or.�aJl s�. 6�lnlaJf '-�o ��d/K A�U.Lv, cfr.��r...� e�.� �.� <br />row�i�ac�.o-� ��o�♦ 6♦ i-t�Jwi.i��% V6 �l�(+ sn�ia��tc�.o.. oT d-�t <br />�7,6/a !✓w-�f J n�iCC�W � <br />l7e'6'ii l.�..o/J �fsQf c�iue�<<f��alr�/�if S.Ft �r e�u 6� C��t�i.rcv <br />u,� aR,� . <br />��1cr -�i� � / /o/ �-, �•�% J t,( e «n d�. �.., /� � s �... f -b N b� �. <br />��i✓// 5C !1C//ki�R.� � ��si�P. <br />✓ <br />� I LtJ� ��� �� <br />APPROV[D AS��ONSTRUCT DATE <br />PERMIT IS VALID FOR 1 YEAR , <br />EXPIRATION <br />Tlie ondarsigned ownor hereb/ pgrcea lo hold end eere hermlpe6 <br />Iho City ol Evorell vom eny ena eu c�eimn lor damepe0. coste, <br />e.peMen, or ceusee ol ecbon Ihel mey erise beceuse ol :nat�llellon <br />.. �J meinlenance ol ��e imp�ouemenl or olher riphl�obwey use <br />herelo epplied lar eml lurihar a0reee to romova e�me upon notica <br />Irom I�e City erf to replace oublic O�operty damsQed i�erohy. <br />ACK <br />POST ON <br />JOBSITE <br />OF ONDITIONS <br />i�- <br />CALL FOR INSPECTION <br />259•8811 <br />241iRS. BEFORE CONSTRUCTION <br />. <br />