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EVERETT, WASH. <br />The Undersigned r <br />Approved By <br />�X �3- 11-'71 <br />Da a Approved <br />Hereby applies for permission to - n '� re ) r ') j a p lr F h�il , - i - �2'` : - <br />At `` a following location <br />SKETCH <br />(Work to be done) <br />t 9a <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims 'tor damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />I <br />A. <br />Inspector's Signature <br />/T�s CsfC� E•=�) A/ <br />Date <br />Call Engineering Dept. 259.68UJ <br />24 Hours before <br />construction is started, <br />g1$R4C7-0 R- <br />z�'-,-mot �c•.s�1Z . � <br />QF— t. ;;• Y. 56C7JON <br />/-141 <br />. r � <br />�S eS�w�rrAaG3 1<rc- <br />u �' A d ss <br />Telephone Number <br />� Dale <br />NOTE <br />CHECK 'WITH WATER <br />DEPT. FOR WATER LINE. <br />LOCATIONS BEFORE EXCAVATION <br />Fee <br />DEPT. APPROVALS <br />171 Engineer 171 <br />Water-Y 7J <br />Street L ,v <br />Communicalions. <br />Traffic' <br />Planning <br />PROVIDE FOR <br />PROPER DRAINAGE <br />DAe-- <br />