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� " / `. i -. ; i .. . . . . . . . ,. . . . . <br /> - I � APPLICATION FqH RIGI17-UFW Y USF PERMIT <br /> i �rrfl �G n_7d' ��p' . <br /> 1 .F� / . '*' /��C,6 � <br /> � ��� /�� > �L� ��-,�..- y �1�.9�:�������,�� <br /> r,irv�ricir�c�ns Jt�j_ ' /�..� 7/n<' /h�:fi["z �lt•ti-' <br /> � GVERFTI', WASfI1NGTON � PEIIMITNO._ 78_ Sj� <br /> � TheUndcrsi��ned. � _,_ <br /> �T � <br /> J hlcreby applics tor pmnir.ivn to lc'A/.:7,C'L'[ �� /'� � �-�lJHi�/ T ;�,['/f��_Q�� <br /> 1 <br /> � � - <br /> At the (ollowiny location __fQ�/ ,� C q n( __� <br /> �� _ <br /> SK[TCH <br /> (Work to bc done) <br /> • ��' . <br /> /� - <br /> �(// � <br /> /�/f� <br /> DRIVEwAY SECTION The unAcrsigned owner hereby aprees to hold nnd <br /> {� NO SCALE savc hmmless the City of Everett from any�ond all <br /> I -� claims fm dxma9e5 Ihet may arise because o/install!- -_ <br /> p �ip � � tion anJ maintennnce of ihn improvement hmeto <br /> ��Q,� I �o„ applied for and further ngrces to remove same upon . <br /> --"---�------�}`-� m�ticc 6om thd City xnd tn repinr.c public prop^rry <br /> da ed tl�u /'Y A _ <br /> - ---- --'-------- S'iynnnturu o��li�t " �w� <br /> LlS21_ <br /> CnPY Of THI; �PPLIC�TION i0 Ai1rS� ��e� - <br /> UE POSTEO UN JOBSITE. _� p <br /> CALL CNGI��fFRIIJG DEPT. 2G9�8811 TeL�phone Number <br /> 7M1 HOURS Ilf-FURE CONSTRUCTION Date — <br /> CH[CK LIST - —' -�------- Fe�7�i�'.7-'.+ 96 <br /> Water Valve Dept. Approvnl5 <br /> Draina9e ' ' . <br /> Curb&Gutter En9incers---------'_---- <br /> Sidc•nulk , -- <br /> -- Watcr.—� _ . -- . <br /> Slrcel---_----l— � <br /> -__.____ . Communicationt___ � <br /> Inspector'sSignaWre , TrafNc <br /> Plannin9--- --.-'-- <br /> a?j te---- ---- <br /> flemmks ------- - ----- — <br /> NaU,: Ori�in:l loCuttomar ---"--- ---- <br /> , �o,,Y ���,�� 17. G? �; ------------�— --- <br /> I Cnpy lo hr,peclor Apprnved by . <br /> , � O,nenpp�ovMl�--_._----------.------ <br />