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�� ,r•�TIrI AI Cf:C) OICLJT_v=-iitAY v�uE o`onnl-� <br />/yfi Ll Vf�..v.• �• ,,, V.., <br />everett �- 10662 L <br />CITY ENGINEERS <br />EVERETT. WASHINGTON <br />The Undersigned L <br />Hereby applies for permission to <br />(Work to be done) <br />J <br />All <br />-4 <br />Z 7,19'A <br />LCT 15 1 Lor <br />J t <br />j in LL� <br />tx <br />G421&ot 14 1-.p3i.2�tYok-( <br />4C7 TA4T fo v-rm IwS CN4 <br />TO BriaW�+Jby. f1'�aHt a... do <br />>`� iJ Inr�c/ fort or' oCr^h-nt✓cKi <br />srJe ff e,r,sr1a, <br />DRIVEWAY SECTION <br />�NO SCALE h 2y <br />I I" LIP <br />30" �30 <br />it <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />5E1;1r74(14 5N41, <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer. +�^ �+ <br />1 Copy to File .11+.) 6 2 <br />1 Copy to Inspector <br />PERMITNO. %6"2�t} <br />N <br />� r1 <br />r/rI PL <br />3 I <br />I J <br />Th= undersigned owner herey agrees to hold and <br />sat a harmless the City of Everett from any and all <br />claims for damages that npily' arise because of installa. <br />tion and maintenance of/the,/improvement hereto <br />further ees to remove same upon <br />City f06 to replace public property <br />4f it —L- <br />1-7 1 <br />� <br />Date <br />2-5— <br />Fee sv 0„ e <br />Dept. Approvals <br />X <br />Engineers :e,4/�,� <br />4�- /-7;1 <br />Communications <br />,/ <br />Traffic <br />Prllanning <br />AOF ti r <br />Approved by <br />nnte Annrnyed <br />