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en <br /> % <br /> pli <br /> '-- CITY OF ANACORTES <br /> (G ` DEMOLITION PERMIT APPLICATION <br /> Site Address: l2- l5 lS1A4. Si. S4 la2c�?. a - nit2 / <br /> Assessors Account No.: 7 7 Z.- crt 2 " cc?>'-COO Date: / -21-Llq <br /> Lot(s): 7 f' g Block it Addition: <br /> Owners Name:ij/i/' -G /f r;F/ Contractors Name: L'4 5 (;02.5';fret-f-7'7 <br /> Address: /z// /-- r ,<-,2 L c Address: /3i. )ij Oa .t cN• /L/'. /✓ �n .?% <br /> State: u/ f., - / State: , ;4 Zip: fAz73 <br /> Phone: / iet) 7_i5 -L'ct� Contractors License: C:Sd /Cfr 9.61 /y v's/ <br /> Phone: (.26o) �, --13341 <br /> Have Utilities Been Notified? Description of proposed demolition. How will materials be <br /> disposed? CMo sf t&s,ofr)CQ- <br /> Water Dept: Yes No /l/p?-L/ & 7,-f.Amiel 77 7>, <br /> Electric: (Yes No <br /> Cable: (Ye s)No `�":cry o c / , (97 f4'L 4/`f/ -- <br /> Gas: &es)No <br /> g% %ftit'A 01- <br /> /L 6-- eitu1/41.\ ` r <br /> BARRICADES TO BE PROVIDED FOR PUBLIC PROTECTION, AREA MUST BE <br /> ROPED OFF! kiL Cr>' -- <br /> Applicant's or Agent's Signature <br /> ASBESTOS WARNING �� <br /> Ocwe, e\& -e__ ° Kid --. Cs <br /> —n9 <br /> Breathing asbestos is hazardous to your health. Before starting a renovation or demolition project, <br /> survey for friable asbestos materials. Notify Northwest Air Pollution Authority prior to asbestos <br /> removal or containment 1600 S. 2nd Street,Mt. Vernon,WA 98273 (360) 428-1617. <br /> Fire Department Approval: �l ......__ 4 Date: S= 5--o 7 <br /> Police Dept. Approval: // Date: <br /> Public Works Department Approval: Date: 5 " 5.-05 <br /> Comments: <br />