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10197 <br />I <br />CITY ENGINEERS <br />EVFREIT,WASHINGTON <br />The Undersigned /-It-T <br />Hereby applies for permission to <br />/-I C- UN'6PE1VED R. <br />At the following location 7 <br />C <br />(Work to be dune) 8—/ VER L Y 3L VD, <br />DRIVEWAY SECTION <br />NO SCALE <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT.259.8811 <br />24 HOURS BEFORE CONSTRUCTION <br />ate <br />Remarks <br />Note: Original to Customer <br />1 Cops, to File O'1 7 <br />1 Copy to Inspector <br />7427 <br />4L� <br />44Q'i <br />""ON <br />IV, <br />S�j•lJ <br />PEIIMIT NO. 75 78 <br />N67E: APPLIONT INAL GET <br />PERMJT Fppm PU, D. F/)k' <br />ACCESS TO AN[> FRDM <br />P, U.D. R -0 -1n/ <br />To 5E L'L E'q'QE D <br />MD GRP DED <br />N SCj1L E <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa• <br />-tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />dammaged thereby. , r <br />74z3 BEMEL Y SL i/D. <br />Telephone Number <br />5-P-7S' <br />Date /;O )�n <br />Fee ,r C._. <br />t. Approvals <br />Engineers <br />Aprc <br />Date Approved <br />I <br />