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EVERETT, WASH. <br />Approved By <br />The Undersigned0 (-,--Y,Ly';_r i?-.S'7- Date Approved <br />Hereby applies for permission to fir,yE D t2,1 NJa uJ Pei % 15 Ltd 17 C- <br />At the following location 171 8 e' F r= t=A 7- <br />SKETCH <br />(Work to be done) <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove same upon notice from the City and to replace all <br />puSlic property damaged thereby. <br />DRIVEWAY bECTION <br />NO SCALE <br />— 15, <br />+la LIP <br />I 30" 1 30 <br />(,JerK <br />Inspectors Signature <br />.S 7E C,yEc r 9-2/ 7Z <br />Date <br />Remarks <br />Call Engineering Dept. 259.8803 <br />24 Hours before <br />construct-`- started. <br />Q& r/�' <br />A4e <br />PROVIDE i <br />PROPER DRAIwGE <br />X <br />Variance Required <br />Yes __. _.... <br />No <br /><s-4as eK, V6r -, <br />Signature of Applicant <br />3 2-1 fog// , JAM [ �K� CK C(�K[Y <br />e,,�ddress <br />Telephone Number <br />Dale <br />c <br />Fee Gf— -�la <br />--7O' %i <br />��/D�EPi. APP�ROYALS <br />Engineta� <br />Water— % t/ 7L <br />Street .° t f._ L I1" A... ; i <br />Communications,��—+ -; _—�; )a�7Z <br />Traffic <br />Planning <br />`NUTL <br />WITH WATILk <br />'�I? VvATER LINE <br />,...z f -r rVr` '/AT1f°` <br />'vw•J <br />mco .ap. <br />