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� <br />r <br />r <br />neveien pppLICA710N FOR PUBLIG WORKS PERM�T / � <br />I I Tvne or wmt ciea,i� w�tn inw `.1 .1 /.J <br />S� PRESS HARD � YOU ARE MAKINC COPIES pEqMIT NO � � <br />PUBL:C WORKS <br />�` EVERETT. WASHINGTON , <br />,f10WNER �] AGENT OATE <br />,�-��-.r!- <br />qpPLICANTiFIRM REPRESENiEO C�iIE�L <br />p ��� C�n c � � <br />ADOPESS . �.i.xL� y '�� <br />L <br />L <br />BLDC. UFPT. NO. ZSol.//'-'���''� <br />����ti�il"iC'U(,"�lJn� -�/V �.. _ <br />CIiV L `�l.�f'!7 <br />HEREBV APPLIES FOR PE�iMISS�ON TO L'D NS�T�'C f' N��`�� S�a 1�`" <br />TELEPHONE ._� SS_ IU/,� . <br />%/17ri. It/ _ l.JIVG'�el_i- <br />- — /_ <br />,1 u.3 0 ���� ���o��y S E� s r _._--- <br />AT THE FOLLOWING LOCATION s,� <br />Attach five (5) copies of preliminary plans to�roposed work. Draw lo scale and show the tullow�^g as applicable: <br />• PrapertY lines and street identity. ' Topographic changes requiring cuts and fflls <br />• Outlfne and dimensions of existing and <br />other than normal foundalion. <br />propo��d slructures. ' On•site draina�e sYstems when required. <br />• Ezistin�� an,3 proposed utilities. ' trosion conlrol inethod/s when required. <br />• Cen;erline ol abutting rignl of waY. � N� arrOW �'�"//'/,j,;/J <br />� �2i?,1 iena r�i�.�� <br />PUBLI <br />CONDITIONS• <br />�`TG��+.� CCr�io.i ci -1�e <br />r <br />�..e►�� ��Sa F � F_ �.,.,,� <br />f��nQ. <br />, , ;: � , <br />�<'� �- ' �J' <br />!��' <br />DFORCONSTRUCTION � <br />(1 ���,,._.,.,_ �.� __ r, <br />PERMIT IS VA <br />EXPIRATION <br />{T <br />c�� •vt...n ...� ,��. �+� -1-� c: <br />o� P'j � 5�. rrr N s f ! L <br />lhe unar�siyncd ownr� ne�eby nB�ee• :o no�a end esve �e�mle�e <br />Ine C��y nl Everell nom eny e�tl su cmme fm O�m�peR cOsl�. <br />e.pen:.el. o� Ceuee6 0l echon I�el mey en�e OaCw�e ol InelMl�llon <br />enA mn��nlnna�ce ol I�e improvnmanl m ol�er nphFo4w�Y usw <br />�aralo epPbatl IOt end lurl�er ap�eee lo romore n�me upon na���� <br />Irom �he Cdy end lo replecc Pu�lic pro0erty d�m�pm� ��ersby. <br />Z <br />-- ACf`�' WLE�GEMENTOF <br />,� � <br />F _ C ��tt��t��� �� / <br />-�-- � SIGNATURE OF��LIC�1� <br />FOR 1 YEAR CALL FOR INSPECTION <br />POST ON 259•881 i <br />JOBSITE 24 HRS. BEFORE CONSTRUCTION <br />� <br />�1 <br />fil <br />'1 <br />J <br />� J <br />