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. , . . , . . ,. . . <br /> � . —`— {� P.FNLtCAT10N FOR (�GHT•OP•WA^Y�,USE PfRMIT <br /> ' � ��� / ��/y' ` ��w ' / <br /> � .u:.ss flrrit-� �/�-i���y��>� :�,v�.Ji�I✓ <br /> I � . :;�:�'� ---.. <br /> I CITY [NGiNC[RS �_"�� //l,�i�Ji9 L �ti��l-f T7�'� <br /> . LVGRf:TT, IVASHINGTON PERMIT NO.__ 7B "�_ <br /> I � <br /> i l7m UnJcrsiqnr.d__ p � � <br /> t �i Hereby oppiics fnr pe�mission to _ �flA;:i7 L�,i-? T /�'y_ '�t�"�jHpZ% ���, � <br /> / <br /> /1t tbc (ollowing Irxation_ (,. ��._�.� j?p, � <br /> SKE7Cli - <br /> �Work tu be donc) � <br /> C / /� <br /> / Z/ <br /> . ���°� �� , <br /> . i <br /> i <br /> , <br /> t <br /> F <br /> i� <br /> , <br /> • a <br /> , � <br /> . � � <br /> � <br /> DRrvEWnY SECTION . Thc undersigned ownen c�reby agrees to bold and �` <br /> NO SCALE save harmless the City of Everett from any and all r <br /> � � -� claims for dama9es that may.arisa becaiwe of installa• 1 <br /> i" L�P 71 tion and maintenance o(the impmvement hereto i <br /> �70„ �-- ' apP�ied fur and further,^.grrtes to remove same upan � <br /> _ ..�.__ .___ ,____�„30"� notice Irom the City end ro replace public properry i <br /> d ged th ( <br /> i <br /> Signature o(Ap ic — <br /> -- 233� d's�� A�� w <br /> COPY OF THIS APPLICAI'IUN TO Addres — <br /> BF POST[D ON JODSITE, _ 3�`S_�'�Q'3 <br /> CALL F:NGINEERING DEPT. 259�6811 � T^Icphone Nwnber <br /> 24 HUURS C[f-ORE CONSTRUCTION Date <br /> -------- ------ f <br /> CHECK LIST Fee 7�����s�j% — j <br /> �Vat�r Valve � <br /> Drainape <br /> Dept. Approvals <br /> Curb R Gutter En9ineers_ <br /> Si�L.walk ------ � <br /> — W;rtcr <br /> Sucet <br /> ____ . Cammunicatinns � <br /> Insprctor's Si9naWre Trallic <br /> Planning__ ___ ; <br /> �ate-------- <br /> Ilemarks"- --------- --- -'- — <br /> tJotr.: Oripinal to Cuslomer n —�----------- <br /> t �oPy tn File .�.�.lJ� C� .. _—..--�--"— -- <br /> � 1 Co;iy to InsPcr.lor Appnr:ed by <br /> i <br /> I -- ----__------'--- <br /> . D.drA��{�.rnved '"'"'""'.._'"--'—' <br />