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r• <br /> 1 <br /> r <br /> 1 <br /> r - - <br /> everett APPLICATION FOR PUBLIC WORKS PERMIT <br /> © AR of- punt clearly won IN. <br /> PRESS HARD•YOU ARE MAKING COPIES PERMIT NO. -- <br /> r QQ'yy ' <br /> PUBLIC WORKS BLDG.DEPT.NO.1CJ���L <br /> EVERETT,WASHINGTON 2/'P/8 3 <br /> C3 OWNER U3 AGENT DATE ---- The Westlin Group _ <br /> APPLICANT/FIRM REPRESENTED --- - - ----- - ----- ------ 778-03.71 <br /> — P.O. Box 1332 -- <br /> _CITYLynnwood_— TELEPHONE <br /> ADDRESS — <br /> HEREBY APPLIES FOR PERMISSION TO __ /�a�" ✓� <br /> AT THE FOLLOWING LOCATION - - <br /> Attach live 15)copies of preliminary plans for proposed work.Draw to scal.r and show the following as applicable: <br /> • Prc.perty lines and street Identity. • Topographic changes requiring cuts and fills <br /> other than normal foundation. <br /> • Outline and dimensions of existing and . On-site drainage systems when required. <br /> proposed structures. •ANarrcW <br /> n control methods whe equlred. <br /> • Existing and proposed utilities. <br /> • Centerline of abutting right of way. <br /> 1111 ure of It an <br /> PUBLIC WORKS PERMIT <br /> CONDITIONS: <br /> �� } 7/w <br /> al <br /> The underelpned owner hereby agrees to hold and save harrrllesa <br /> the COY rs Ewalt from any and all claims lot damages. Coate, <br /> e.penses,or causes of action that may arse beuuee d installation <br /> and maintenance of the Imprdvament or other rloht'W'wey uae <br /> hereto applied for and further agrees to remove same upon notice <br /> from the City and to replace public property damaged thereby. <br /> p�y� p,� 7 J <br /> ATE ACKtIiKEq 7 T I S ,� , 9J <br /> C N 2 ccFF <br /> DA—ij DTE <br /> TE SIG T EOF APPLI NT <br /> P VED AS NSTRUCTED CALL FOR INSPECTION <br /> L PERMIT IS VALID FOR 1 YEAR POST ON 259.8811 <br /> AT <br /> 2 3/� JOBSITE 24 HRS.BEFORE CONSTRUCTIO <br /> EXPIRION N <br /> l <br /> J <br />