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At the followirg <br />•ll. " fN —rJ NI <br />l•'D. <br />(Work to bn dnnel <br />BEVEULY 3LVD, <br />74Z 7 <br />A>.Qy <br />DRIVEWAY SECTION <br />NO SCALE__ <br />k3o" 30 I <br />(COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />Note: Original to Customer <br />1 Copy to File 10197 <br />1 Copy to Inspector <br />D74Z3 <br />A167-E-: APPLIOMT 11VAL GET <br />PERMIT FRI319 ROD. FI)R <br />ACCESS Td AM[) FR6M <br />PU.D. R-U - 01 <br />/3R[,� TO 5E r1 EpgE )D <br />HIVD (SRA DCCJ <br />�y Z <br />AM -yopt E <br />The undersigned owner hereby agrees to hold and i <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 />4 notice from file City and to replace public- property <br />daTaged thereby. <br />SiNature of Applicant <br />_.L. 11n.Sc_r <br />ANdress-��f-- <br />7423 8f_ VERL Y EL VD. <br />�U) Telephone Number <br />�NI <br />Dee MOO F�Z- <br />i <br />Q..Q1B�t,J� Approvals <br />Engineers lam-= ,?- <br />�iJc"Lt4L,6vLG//��-lS <br />App' . l Lr� <br />D <br />Date Approved <br />