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6533 BEVERLY BLVD 2016-01-01 MF Import
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6533 BEVERLY BLVD 2016-01-01 MF Import
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Last modified
5/12/2017 11:52:34 AM
Creation date
1/23/2017 1:07:34 PM
Metadata
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Template:
Address Document
Street Name
BEVERLY BLVD
Street Number
6533
Imported From Microfiche
Yes
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j�'/�" L_=.� �I ��' 7� <br />The l�ndersigned � ;" ' � � � � � � / _ ' Datc Appro�ed <br />Hereby applies fur permission to�' � � � _ ' 1' <br />At the following locati <br />SKETCH <br />IWork to be donel <br />The undersigned owncr hereby agrces lo hold and save harmless �hc City o( <br />Everett (rom any and all claims for damages thaf moy arise because o( �he <br />i�itallaticn and mainlenancc of ihe �mprovemenf hcrelo applied (or and <br />fur�her agrees lo remove same upon no�ice from the City and lo replace all <br />public properly dumaged ihcreby. <br />Inzpecfor's Signalure <br />_sir� C,�.�c-c��� -� /G-7i <br />oaia <br />�a�� �.fli II f'fl�d� �)U� �. L�7J-d��.i <br />''�, Hour bek,re <br />�'��s'�uction is starled <br />_ � <br />Q� <br />.`� / V <br />\ � ,�� <br />�, <br />` <br />\ <br />i�,�J��;;. <br />-- - - _ . ._. , _.._ . _. .. <br />f PI'l;,d;. � � � <br />I i r;O��L`c OItAIfv�;GL <br />i I <br />�- ----- __— ----' <br />� � `�, ._n:., <br />-4 i.� <br />� � Signofure ol Applimnt <br />'� � � ;� � ,!-. ,., .,. /;`,.;.-. <br />� Address ' <br />-i_ � I <br />Telephone Number <br />Date <br />S ��i � / � / <br />Fce <br />DEPT. APPROVALS, <br />// r <br />Engineers�� �r/LC� �'��/ /�/ <br />� Walcr J✓•r � c c-�•-- �/ `! i' 7% <br />Strcef � � <br />'� Communical,om. � +��•• —- /•.-..-. <br />Traffic ''� �% �' � <br />� Plannin' t.,�� L' s"f Z'•7 � <br />i <br />---�__ � <br />r�o�rr: � <br />,\ <br />�c ��;I� � . ..� , <br />, „� � � <br />�{ <br />
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