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°"w APPLICATION FOR PUBLIC WORK <br />�/� <br />PUBLIC WORKS <br />Type or pnnt clearly wil� inM <br />PFESS HARD • VOU ARE MAKING COPIES <br />EVERETT, WASHINGTON Q / �i <br />�OWNER ❑ AGENT DATE "/�' `� a a <br />APPLICANT/FIFMREPRESENTED�/����5 %�%7'�S.TC.� <br />S PERMI'T <br />PERMIT NO. ���j" 1— __ <br />BLDG. DEPT. NO. J`�/�1 4D % <br />ADDRESS 0_�`F'_ _S�E_�r����L CL�y _ CITY _�Y_C���%-TE1_EPF.ONE ����Z <br />HEREBY APPLIES FOR PERMISSION TO ��57�� a S� Cv�.�� ���LYe�['T� �/U�`lS��__ <br />ATTHEFOLLOWINGLOCATION LL'% �Iy (��-r(«�� .,'� .��l�i�J'��db_�S _!�/ SL�U„ <br />f <br />Att�ch (ive (5) copies of preliminary plans for proposed work. Draw to scale and show the following as applicable: <br />• Property lines and street identity. <br />' Outline and dime�sions of existing and <br />proposed structuros. <br />• Existing and proposed utililies. <br />• Centerline of abutting right of way. <br />CONOITIONS: <br />• Topographic changes requiring cuts and fills <br />other than normal }oundation. <br />' O• drainage systems when required. <br />osion contr I met ods when required. <br />• orth ro � <br />�_� _ .s�a�aiylo oi araiicnm --- ---- - <br />., 1 / <br />� (7 /�P.. � aP/% iQSPri+P�+7 s?���C_ / 3 Hu � -�i ��' CY�4r�.� , <br />a• ��(JO T' %b� C7/[I /.n 4J C_ IHNS� hl. L%O�! i'r4 �//�.O Ort �C �OT� <br />/% / L� <br />,3. /Fj� A�nq)C �>.- ���CR,�n3 e ��u .fuEi�iC �/LU O[Ctrri�rs` <br />/� / / /7 / o' <br />dN[ � LYJ�73�KfY-IU.� ��swli- 6C l��Qli/..Y d�s <br />/ <br />G.,,� ��. <br />� ��G.-;r -f��J�,��.1� ,..l� � 6/� �'/� -{,.... ��� <br />Cc7rJS�/'Nt�iO.-� J�%P i3 � �ic C��OrJCc(/ !/,rl C7'�'✓.q. <br />�% � «S�' w �t'r s�r �, � e. � �K'� - a �% ho r � �-.N.�'� <br />,�, � ;,-�a�. <br />��� ` <br />� � 'O L_ // <br />VED FOR CONSTRUC I� DATE ` ( AC <br />/ <br />. ,, _._ .� <br />, � - <br />--c -s' �, ��- �=_._ _ _ _ � � � <br />APPROVED AS CONSTRUCTED DATE ��� SI( <br />PERMIT IS VALID FOR 1 YEAR pOST OJ6 <br />EXPIRATION JOBSITE <br />The unders�gned owner �ereby apreos to �a10 and eeve hnrmle:t <br />Ihe Gty ol Everell twm eny a�a an cunne lor dameqee, wcb. <br />erpen585, or wunee ol BCllon Ihel mey enee beceueB ol inaldlaUon <br />ena meintenence ol t�e Improvnnient or ot9er riph� p4wey use <br />harelo apVhed lo� and lurl�er egrcee lo mmova seme u�ron nollce <br />Irom I�e City antl ta replar.e publlc prapetly tlemn0� ��erBby. <br />CpNDITIONS <br />C�-- <br />T_ . . _ . -DA1E -�---- -- <br />CALL FOR INSPECTION <br />259-8811 <br />24 HRS. BEFORE CONSTRUCTION <br />1 <br />_J <br />