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2014-09A ROW Permit 06022014 01/11./2013 FRI 9- 06 FAX 360458841 1 C.i,tYoffVehn Pr.bl°lkc Work, (1o4)4/P.o4 ' o t City of YOM Permit loo. PUBLIC WORKS - 901 Rhotan Rd MV Application to Perform Work on Yel►n,WA 98597 Public Tight of Way and/or Connect Phone: 360-458-8406 to Utilities .; -.. FAX: 360-458-8417 APPLICATION 3 tries a alication to: flt�:uc�lcit~1 si mmPlcd lrerelay°ul.. _ Location of`work: e I agree to aerforril the work in_strict.-compliance with Yelai Municipal Code,.�C ha ter __. the special conditions enumerated herein and the attached conditions I have read and will adhere to the general provisions a plicable to jLi%i contained on this farm. _ The Public Works Department(360 453-8406)must be contacted far insnectiort 24.hnurs before work con,file or this p+e rn.� it r i1,1 be yule/. The Underground Utilities Coordinating Council(1-800-124-5555)must 6e contacted two(2)working days befor eedin with any excavation associated with this permit. Address, Pro p ose g _ l ..1tlratPOn: � d startin date ofirast<lll��tra�lt: I' Date; Signature: a, I i'l lt.h;awl L'l S _.. For Official Use Onl Issued Fee Received$ Application Approval Itecei at'�uni t Signature: 1 _._�m__ .. ............ . ___ To Be Permission is hereby granted to perform the above described work subject to the general prow isions contained on his form,and the conditions: ..�., ..._._.----- _.. n"a— required with the above A bond in the amount ol'w m__........� Ps re uPna�l to�rl�albr�com.. ..���-.���..� conditir,')ns,1 1t1ndabic upon satis at t��ry� �t'o�tlal�ti�wn� ,...... .� .. tvo work shall be clone under this ermit until the p m& t €�1 parties to vrl�lor��lt...�...ranted s._._._._w m_.......... .....�_.� �. p p y l I g hall have communicated with and received instructions from: l�ers7ilrl�9 w t 1r sP Yoasg�c rdon /nape for Final nloyect ��r Pate cm letlon� lrovai .�...� Revised 03/09/20 1 c,�x MQvEL 8 N i�iApry�uyn^vm"ry�p�'�I <p Yw Z� 0 L�aN v w� o �O� V pp r I N 4 G M t e01 Q 3S 08 3AONJ � X M L r f CID r W2�0•� _. 4I p ..................... w w g asp W 0 r X I Q z ¢LL U > Z J Q C�O�� Y ''.W 2 K E C7 Y Z Em{. '� [I I� O p Z W L I ® `� � L �io ik I I L.�..W,. V �V M M N � wv.. Z O O'O O 10 M 04 lulu = Oleo CL Z N CASAVANTS LN(PVT RO I O z M M W ZV.� c m Q> Z 20«�( Q O DO O a n a E is Q C 00) N m V (n 0 0 m E Q--) `0 m a� Lr) LO 0 E � E I 6OZM E m � � c m �_. p N N j t6 N O p> O O1 N L0 L0 0 U N N c NJ Q Iyr i w N N'M vi t E ui a1 '�"u F- m y 3 y 'E o d c I s a = o N Lo •V .�. j N�? N N O N C ^O N F=- ww M N N N o_—_ I M a _ Z a _...... ....... Y N m N d c L_—_------� O Ill O m U N C Q y 3 > N � p O 1A t0 00 f6 (O U N U N U (O l6 [0 w M '.. c a0i a,i c .N n ui o a m I RANG UMil']Y En SE ¢ o ICY r I c v 3 r '� U a � In In In iii F= nL o1 ? W N Z r (O N U M 4 O In (O (O cis W I �. (z4t I�MWi. '" — MkJb N r 00 z .... o N 'Vw.N'9tliK ca O C CN I AHEAQ 16644w �� .. 16628 a9'` R � _ n 4 i 10223 I 510"E tl,r 16 16624 I 2 M ry �ss 16700 10239 16108 i 16716 1 64 � , ���< � i nr -- ' q I ' n .. _A E ` � t1l t�u 1031dAve 5F "tl 977 0 � r v 1660s 16623 V 516"MPE 94 1898 h , 108 5/B"MPEI 2002 5/6"PE 16707 1993 16637 9 r 10322 10328 10321 � 1 10336 4