Laserfiche WebLink
r <br />everctt <br />� APPLICATION FiOR PUBLIC WORICS PERMIT <br />TyOo or piin� c�early wlih Ink , //// <br />PRESS HARD • VOU ARE MAKING CUPIES �S r/ z 2 <br />PUBLIC WORKS PERMIT NO. � � ____ <br />EVERETT, WASHINGTON <br />O OWNER 1jJ,AGENi DATE � I JI f_v I._ BLDG. DEPT. NO. _____ __ _ <br />APPLICANT/FIRM REPRESENTED _�E.I.. IKQ�L WI��(%�.1,Y ________ __ _ <br />ADDRESS "�� �� ___ CITY ��-�j1�t�t�TELEPHONE ?i " <br />HEREBYAPPLIESFORPERMISSIONTO —_��{� rL_�I,AU�1-'j1prl _�__ r-iL,��= - r��_(,1J� ��f)�kr <br />ATTHE FOILOWING LOCATION _� �t�I_,�l!'� � I � T�� ` _ �,-����r- <br />_. . �---= - f - <br />Attach five (5) copies ol preliminary plans for proposed work. Draw to scale and show the following as applicable: <br />! <br />• Property Iines and street identity. • Topographic changes requiring cuts and fills <br />' Outline and dimensions of ezisting and other than normal foundation. <br />proposed structure^. • On-si drainage systems when required. <br />' Existing and proposed utilities. • Eroci n control methods wh n required. <br />' Centerline of abutting right of way. • Dlo h rrow <br />- - �/_ i� e-r%��V�__ <br />Si ature ol Ap�icen� <br />PUB- - - <br />CONDITIONS: <br />a, N� oPe.. cuH �.,5 oF Il,,�` <br />. C�c tP� o..�� ��.� CiS�w.t rJ' <br />: WORKS P RM <br />(�./. w. ..,��1 be <br />� � N 1l U I <br />h1l o{bo. �.i',I.# �oso�.,�� �..we� b. <br />i...�L. CIA�i.�o� oi{ o�. Ib�' �, w beiw�t� <br />R0.ff�GGa\i� M•i�� �pQ <br />�.a._�A,�.s -� i�.� <br />c.11., �... .�[ ' e a c t P! -�`•� <br />� icp�� S ��uss .�/.� �...-�er ey�lrw. <br />bo r r�- �o � Jv � �y <br />15+�' a..�{ $O+� 1t a rov�✓ <br />�\nt.� c-1 L,oJI, p�.�� Uj <br />.,.��,�1���� �o.. �� +�.. <br />n.� `il.e [..�.1 "Cro�,i <br />w..� .� �a.. o�. {Io.. � R c� <br />-lo �l.a s..1 �sl r.c� �o.. <br />c�a'�:�o�= +1� :��p �� �.+�. <br />EN«�,k- a� Ho�.s� a�,O.,. <br />`PP^°„�S� f�-��L <br />��ss,Snr�L�aciclmcs - 6�dS $ - 17Zo <br />9 - IbLO <br />. 1 O - IS ia <br />�i ' ly �-O <br />� � L — ( } ,2 O <br />' S3 S1 �3- �izo <br />PROVE FORCONS CTION ATE <br />C - �� ��� i` - - <br />fiPP , {{:g - � DATE <br />PERNfIT IS VALtD 1�OR 1 YEAR <br />PP - <br />blo cic a�,S.�: <br />�,..bli� l.�urkti J�.�,.v <br />UVOi I�u+� VNNSF tl< M/1..�I«�w.S <br />(�...�.\.i �vur�cS �..��.f�io� <br />� � aay� �w.... ��ro.,.�( <br />..�\ wo�l� s6a.�� be Pe� Pla..s <br />POST ON <br />J06SITE <br />Th�� undnBipneJ owner �oroby egrees lo hol0 anU •tave �enNcee <br />Ihe Cily ol Everell trom eny eno au cielms lor A�m�pee, coels, <br />e.pen�os. or �eueee ol eclion Ihel may etlee beceusc ol lnelallellon <br />end meinlenencu ol �he Improvemanl or other rlpM�o4w�y u�e <br />haralo eppbed lo� end Iurihe� eprae! lo romovo semn unon notica <br />Irom Ihe Ctly end lo raplece publi� propatly Eemape0 ihereby. <br />NT OF ONDI ION <br />' ���� ` ' -� � <br />LICAN �� pATE / <br />C/iLL FOR INSPECTION <br />259•8811 <br />nw un� orrnnrrn��cro��nr�nu <br />� <br />J <br />l <br />