Laserfiche WebLink
"'`re" APPLICATION FOR PUBLIC WORKS PERMIT <br />� TYOe or Ptlnl cb�dy wllh Ink !� <br />PRESS HARD • YOU ARE MAKING COPIES pERM1T NO. �"-'�- l <br />°UBLIC WORKS <br />EVERETT, WASHI TON �f BLDG. DEPT. NO._ <br />❑ OWNER AGENT OATE ._Y �� 8��yy ����� ����,�„��� �j��o <br />APPLICANT/FIRM REPRESENTED ._— — �%P� ! _���-!I_C�I_ _ �/'�11�5_ ,iy�y <br />ADDRESS qlZs .LF���c.15� CITY/��S�TEL HONE�3Z•.�5�3 <br />HEREBY APPLIES FOR PERMISSION TO .t7��/(S� l/�XG�j,s I�CGd�/dJ�' O/J (���7 <br />sr-sr[�/ SI�{G �S/�—=J—�S�s-/_%� _li�Y�_�S_LO�P o�_J,S�j W . <br />. . „ .- .. . . . <br />AT THE FOLLOWING LOCATION <br />Attach five (5) copies of preliminary plans for proposed work Draw to scale and show the following es applicable: <br />• Prop Iines ond si�r e �dentlty. • To�eg hic cr@�s�qui�ing cuts and Iilla <br />• OutNno an ' n�ons of existing end olher tha I�undation. <br />proposeq,etfuct • On•site i age yste a-w required. <br />Existi �d proposed u i ' s. Er co rpl e swh� n req . <br />' C erline of abutting right o ay. • arrow �<�—�l <br />i <br />.� <br />CONDITIONS: V <br />�..�.. . / � <br />, ... .� A�,�, -'C✓�Rn�� t-/�� �df �' c'fCc'P <br />/l <br />. . �3 <br />' : : : 3��c% �� <br />�... � C;-�, �,o�l �d>>Z��u( ���,� [ � d� �rs' Er,//E �.{� <br />T� � ,!�aTi.r t�, cti..72 � f" >!�-� ,' �. ;, / � C�k�i `s <br />. .� /�,iiC��'[ 7�z� r'- <br />/ <br />i . . <br />F-' . .._ . . . . . . . . . . . <br />�.... . <br />� _�.._ .._ . . . . . . . . . . . . . . . . . . . <br />i- <br />� <br />PERMIT IS VALID FOR.�A <br />. ?� , I_L�. S <br />�........ �..... <-�i �� �u' '� I <br />Tha undeniqnee owner hereby �areos to hWd �ne �rve na�minna <br />I�e City ol Evemlt trom my ena eu c�alm� lor Oam�peR coel�, <br />o�panne ueee ol ecllon Ih�t m�y �d�s bec�u�s ol Iml�ll�llon <br />end Inlenxnc ol the ImO�ovemenl or ather tlpAl�ol�w�y uan <br />here a0'���e0 lo� e tl Wtlher epreee to remove ��me upon noucx <br />lrom Ina Qity �nU 1 repiecn public MopertY d�maped Merobv <br />'��/S/` A I n 9� 1 1 <br />sid� aE -Fdhfiu w' v onre <br />CALL F R IN ECTION <br />POST ON 259•8811 <br />.ICiBSITE n• �no esrr�+nrnn��nrm�nT�nu <br />� <br />� <br />�f <br />