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� <br />L� <br />GIT'( ENGINEEFS <br />EVERETT.WASHINGTUN <br />10724 <br />PERNiITNO. � " <br />The Undersigned _ L '-. HaAI �;. i,�y�_ _ _._._ ___ . -. _ <br />Hereby applies for permission to ;,�! �'." � _. - i 7' �i:�.v:+.-i J�.� �S <br />At the to�lowing lota[ion �. .`2� <br />SKETCH <br />(Work to be dnne) <br />� <br />OkIVEWAY SECTION <br />NO SCALE <br />r--- --- - - -� <br />�_�.I'_LIP___ __� <br />�30,� � _ _..__ �30"« <br />COPY OF 1HI,Sl�PPUL:A �'IUDI �i(� <br />BE POSTEJ ON JOBS!T� � <br />cni i_ � rar;inn;t��r��r�i�, i,ri�� 25a-He i i <br />7-1 I I(IUH:; IkF I(H�I �'i �iJ', I ItUC:T�(1N � <br />CHECK UST <br />Water Valve <br />D�ainage <br />Curb & Gutter <br />Sidewalk <br />- -.---- -�— --------- --� <br />Inspector s SignaWre <br />�, <br />�te � _ <br />�' � �.7 - <br />Remarks <br />Nme: Original to Customer <br />1 Copy ta File '� n 7�(1 <br />1 Copy to In;pec•or <br />�c,'" ,I �,-.�, ��_��� <br />The undersi{�ned owner hereby agmes to hold and <br />save harmless U�e Ciry ol Everett from any and all <br />claims for dama9es that may arise because e( installa� <br />tion and maintenance of the improvement heieto <br />applied 'or and furiher agrees to remove same upon <br />notice from �he City and to replace public properry <br />damaged t�,ereby. �� �� n <br />�.� 75� �z`-� <br />Signatur plic <br />��.�, — <br />Acldress <br />�3S��S /Srwy y% ��wa..-D.� <br />Telephone Number <br />Z7S— 3.sa 3 _ <br />Datr <br />� —� �' 77 <br />Fee —�'�i — <br />/ % � t[' . ---- <br />Dept. Approvals <br />, I .l qL-4�7"'4'ess'i-- <br />Engineers_�p <br />Water + 7 � -�"i�.., , _./_�.. - <br />i �_� . " <br />Street�{ ' / _ <br />--�--`�-�--- — <br />Commurications <br />Planning.__T_ -- <br />C , : . . �.�+1. a /��,. ��.. _ .�y�_ <br />.1 � / <br />Approved bV � <br />. .__.'__.�_L_1__.. . __.. . _-_ _. <br />Uatr 11pP�ov^d <br />