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7901 BEVERLY BLVD 2016-01-01 MF Import
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7901
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7901 BEVERLY BLVD 2016-01-01 MF Import
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Last modified
5/21/2017 8:24:10 AM
Creation date
1/23/2017 1:41:51 PM
Metadata
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Template:
Address Document
Street Name
BEVERLY BLVD
Street Number
7901
Imported From Microfiche
Yes
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CII'i [IdGIIJLL'r'L <br />EVERETT, WASH. <br />Approved By <br />, I _���Sl1i� v � �j?. <br />The Undersigned_ �! O�1 E � t.1 ��(� t� �l �, Daic Approved _ <br />Hereby applies for penaission fo !�.� u �'t, _ � ^ ;'� .� -_ '�_� ii,�%n r�� ��� <br />At the following <br />SKET�H <br />(Work to be donel <br />, <br />��— =="-- <br />/,� ' 6� � <br />J <br />� <br />/ <br />i"� �` , � \ <br />�'(��`, tp'� <br />� T li� <br />The undersigned owncn c�reby agrees to hold and savc harmless the Ci�y of <br />Everetf from any and all claims for damages Ihal moy arise because of Ihe <br />installation and mainlenance of Ihc improvemenf herelo applied (or ond <br />(urlher agrees ro remove same upon notice from Ihe Cily and �o replace all <br />public property damaged thcreby. <br />Inspeclo�'s $ignofure <br />�%i%. l fi�Gc � % '2 /c �J� _ <br />Dale <br />;; ',i � �i�;ineering l:epL 259�IIEUJ <br />?4 Nours 6e(nre <br />; -�;;�n��tlor �,tarlCd. <br />�a <br />`,! �)'i E <br />�, � �" ' ": 1"Jli'FI 1NATER <br />� `i:4 lY:1TEH Llt!c" <br />t r�„ - ir�'��_ .��-I li��- ��. � <br />_ I{)�rr.,.71��.J <br />�� <br />34�� <br />�v <br />l�lv��-; Gv�r�.�.SH�� o�-� <br />1�.� � �F T L--�-l1-�:9r�v <br />�9�V0 P��c; v Oci�s�o` <br />O/= .S'ilJ�WA/� BEt�,�.� <br />/ ��-�C-;��t/G CC>it.�C.P_F-i� <br />Variancc Required <br />Ycs ._ <br />No <br />�/ � � <br />Signafu�e o1 Applicanf <br />�7S1�1 .) � t,� rr�F f�?v t�.'c; <br />ndd�e,: � <br />_ �s ; - ..� � _;:,1 <br />iclephone Number <br />��-►1-�Z. <br />oar� <br />S �.i f� 6�' �' LT <br />Fee <br />D�E/PT. APPROVALS . <br />Enginceri� �i L .`'C.(//J!/�'2/�f /7L_ <br />Walcr. l�w` T :�- /`/' 7� <br />Streef . . . . .' -._.. _ . <br />Communir.olioni �" J! _ <br />Tm(fic ' ` -:,i�..'' - - <br />Planning S .1 - /y- , 7 L <br />�-�. ... ..._. <br />...__.-._...,� <br />
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