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816 BRUSKRUD RD 2016-01-01 MF Import
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816 BRUSKRUD RD 2016-01-01 MF Import
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Last modified
5/19/2017 8:55:23 PM
Creation date
1/24/2017 11:22:24 AM
Metadata
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Template:
Address Document
Street Name
BRUSKRUD RD
Street Number
816
Imported From Microfiche
Yes
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Hereby applies for permission to <br />At tbe fallowing locatian �� �� — `���'� ------- ----- <br />(Work to be done) <br />c�cC nC FY/CT/Nr <br />DRIVEWAY SECTION <br />NO SCALE <br />-7 � --------- <br />r----- � / <br />�I�� LIP � <br />q � <br />30" __ .__-J7� � _ _____�30� <br />/ <br />COPY OF THIS APPLICA710N TO � �, <br />8E POSTE D ON JOBSI TE. �' <br />Cl1LL ENGW[FRING DEPT 259�8N11I� <br />94 Ii0UR5 fSfFORF (:flNS�iRU(:l IO�;'',. <br />.� � . `� % " <br />) - <br />ate � � <br />���� %� �-"��- � . <br />Ramarks <br />Note: Original to Customer n <br />1 CopV to File �' ! t,�j 2 <br />1 Copy to Inspector <br />�.� 1,� <br />I ne unaefs�gnen owner nerauy ag�ees w nwu mm <br />save harmless the City ot Everett irom any and all <br />claims tor damages that may arise because of installa• <br />tion and maintenance of the improvement herelo <br />applied fo� and further agrees to remove same upon <br />notice trom the City end to replace pubtic property <br />da ged thereby. n <br />�3.� � � p�"�.e� / <br />S� awre o�A p �cent � <br />.. ` .�.� �' �. r- .�ti. <br />ddress � <br />" _ !_ <br />ephone Numbe� <br />_ ,�_ ' r" _ <br />Datel <br />� SO ,_'.�=� . � r <br />Fee <br />AP����[br ;i�� ��/�.0 ,c.,. 7�� <br />,Date AKproved <br />
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